Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (1): 28-32.doi: 10.6040/j.issn.1673-3770.1.2019.051

• Clinical Report • Previous Articles     Next Articles

Temporal bone trauma complicated with cerebrospinal fluid leakage: a case series and literature review

Juanjuan GAO,Xin LI,Jia XU,Wenjing CHEN,Sichao LIANG,Zhenping GUO,Manlin LU,Haijin YI*()   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
  • Received:2019-08-27 Online:2020-01-20 Published:2020-03-06
  • Contact: Haijin YI E-mail:dl7599@163.com

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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

CLC Number: 

  • R764.21

Fig.1

Temporal bone high-resolution computed tomography (coronal position) indicating bone discontinuity at the right tegmen tympani"

Fig.2

Temporal bone magnetic resonance imaging (coronal position) indicating a long T2 signal at the right tegmen tympani"

Fig.3

Computed tomography cisternography (coronal position) suggesting bone discontinuity at the tegmen mastoideum"

Fig.4

Temporal bone high-resolution computed tomography (horizontal position) suggesting IP-Ⅲ deformity of the right inner ear, and bony defect at the fundus of the internal acoustic meatus, which connects directly with the cochlear basal turn"

Fig.5

Temporal bone high-resolution computed tomography (coronal position) indicating a bony defect at the right fundus of the internal acoustic meatus, which connects directly with the cochlear basal turn"

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