背景:本病例系列报告旨在介绍三种用于治疗脑脊液(CSF)耳漏的手术方法,提供侵入性较小的手术选择来管理这种情况。方法:26例脑脊液耳漏患者的临床资料,对2012年6月至2022年6月期间使用三种手术方法进行治疗的患者进行回顾性分析.该研究收集了有关患者基本人口学特征的信息,首席投诉,缺陷的位置,耳漏内镜检查结果,颅底薄层计算机断层扫描(CT)检查的结果,和脑脊液耳漏的原因。随访脑脊液耳漏的术后转归。结果:26例脑脊液耳漏,有13名(50%)男性和13名(50%)女性接受了三种手术方法的治疗。脑脊液耳漏的病因包括自发性脑脊液耳漏10例(38%),其中先天性内耳畸形2例(8%),无明显诱因8例(31%)。此外,有5例(19%)创伤,胆脂瘤并发症6例(23%),脑肿瘤术后并发症3例(12%),1例(4%)放疗,1例(4%)恶性肿瘤。对12例(46%)脑脊液耳漏患者进行局部修复。此外,3例(12%)患者接受了缺损的局部修复并封闭了鼓室窦入口,11例(42%)进行了局部缺损修复,并密封了咽鼓管和外耳道。术后6个月至10年随访期间未观察到脑脊液耳漏复发。结论:三种方法治疗脑脊液耳漏,包括局部缺陷修复,局部缺损修复结合鼓室窦入口封闭,咽鼓管和外耳道的密封,在适当选择的患者中显示出成功的结果。
Background: This
case series report aimed to present three surgical approaches used for the treatment of cerebrospinal fluid (CSF) otorrhea, providing less invasive surgical options for managing this condition. Methods: Clinical data of 26 patients with CSF otorrhea, who underwent treatment using three surgical methods between June 2012 and June 2022, were retrospectively analyzed. The study collected information on patients\' basic demographic characteristics, chief complaints, location of the defect, results of otorrhea endoscopic examination, findings from skull base thin-slice computed tomography (CT) examination, and causes of CSF otorrhea. Postoperative outcomes of CSF otorrhea were followed up. Results: Among the 26 cases of CSF otorrhea, there were 13 (50%) males and 13 (50%) females who underwent treatment using the three surgical methods. The etiology of CSF otorrhea included 10 (38%) cases of spontaneous CSF otorrhea, including 2 (8%) cases of congenital inner ear deformity and 8 (31%) cases without obvious inducement. Additionally, there were 5 (19%) cases of trauma, 6 (23%) cases of cholesteatoma complications, 3 (12%) cases of postoperative complications of brain tumor, 1 (4%)
case of radiotherapy, and 1 (4%)
case of a malignant tumor. A total of 12 (46%) cases of CSF otorrhea were treated by local repair of the defect. Furthermore, 3 (12%) cases underwent local repair of the defect combined with sealing of the tympanic sinus entrance, while 11 (42%) cases underwent local repair of the defect combined with sealing of the eustachian tube and the external auditory canal. No recurrence of CSF otorrhea was observed during the 6-month to 10-year follow-up period after surgery. Conclusion: The three methods for CSF otorrhea, including local defect repair, local defect repair combined with sealing of the tympanic sinus entrance, and sealing of the eustachian tube and the external auditory canal, demonstrated successful outcomes in appropriately selected patients.