颞骨外伤并发脑脊液漏18例并文献复习

doi:10.6040/j.issn.1673-3770.1.2019.051

摘要/Abstract

摘要： 目的

分析颞骨外伤并发脑脊液漏的临床特点，探讨其诊断及治疗策略。

方法

回顾性分析18例颞骨外伤并发脑脊液漏患者临床表现、辅助检查结果、手术方式、术中探查结果及预后。

结果

17例颞骨外伤并发脑脊液漏患者均一次手术成功，随访期间脑脊液漏未再复发；另外1例患者脑脊液漏第一次术后1年复发，行二次手术，随访至今未复发。所有患者均无术后感染发生。

结论

对于保守治疗效果不佳的颞骨外伤并发脑脊液漏患者，手术探查修补是最为有效的治疗方法，经乳突入路或经迷路入路脑脊液漏探查修补术均取得良好的手术效果；术前的病史、临床表现、实验室检查、影像学分析对于脑脊液漏的诊断、瘘口定位及具体手术方式的选择非常重要。围手术期抗生素预防感染及酌情使用药物控制颅压，均有助于术后恢复。

关键词: 颞骨外伤, 脑脊液漏, 诊断

Abstract: Objective

This study aimed to analyze the clinical characteristics of temporal bonetrauma complicated with cerebrospinal fluid (CSF) leakage and to discuss its diagnosis and appropriate management.

Methods

Eighteen patients with temporal bone trauma complicated with CSF were analyzed retrospectively.

Results

During follow-up, no CSF recurred after the operation except for in one patient. In this, the CSF recurred, a second operation was performed, and the CSF leakage ceased. No postoperative infection occurred in any patient.

Conclusion

Surgical exploration and repair is the most effective method for those who have poor outcomes with conservative treatment of the temporal bone trauma. Medical history, clinical manifestations, laboratory examination and imaging analyses are all essential for diagnosing CSF leakage, locating the CSF, and selecting an appropriate surgical method. Perioperative antibiotics to prevent infection and appropriate drugs to control cranial pressure can improve postoperative recovery.

Key words: Temporal bone trauma, Cerebrospinal fluid leakage, Diagnosis

中图分类号:

R764.21

高娟娟,李欣,许嘉,陈雯婧,梁思超,郭振平,卢曼林,伊海金. 颞骨外伤并发脑脊液漏18例并文献复习[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 28-32.

Juanjuan GAO,Xin LI,Jia XU,Wenjing CHEN,Sichao LIANG,Zhenping GUO,Manlin LU,Haijin YI. Temporal bone trauma complicated with cerebrospinal fluid leakage: a case series and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 28-32.

图/表 5

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