持续性脑脊液耳漏的诊断与治疗

目的：探讨持续性脑脊液耳漏的发病原因、临床表现、诊断及手术处理方法。方法：分析1987年6月－2000年12月收治26例持续性脑脊液耳漏的临床资料，男16例，女10例。成人18例，儿童8例。结果：26例中自发性脑脊液耳漏14例，因乳突及侧颅底手术引起的12例。15例伴有复发性脑膜炎。26例中25例在我院1次手术修补成功，1例听神经瘤术后脑脊液鼻漏行2次手术修补成功。结论：手术是主要的治疗方法，术中应注意颅底的修复，尤其对内听道、鼓室、咽鼓管、乳突尖等重要部位的处理，以预防术后脑脊液耳漏的发生。

Diagnosis and treatment of persistent cerebrospinal fluid otorrhea

Objective:This study aimed to review the pathogenesis,clinical situation, diagnosis and surgical management of persistent cerebrospinal fluid otorrhea. Methods:Twenty-six cases with persistent CSF otorrhea from June of 1987 to December of 2000 were reviewed. Results: The causes of CSF leak were spontaneous in 14 cases, mastoid and lateral skull base operation in 12.Recurrent mengingitis were diagnosed in 15.25 cases were repaired sucssesfuully once, one case was repaired twice owing to CSF leak after auditory nerver tumor surgery. Conclusion: Persistent cerebrospinal fluid leak often presentsrecurrent meningitis and result in false diagnosis and treatment. Surgery was the most important treatment. Skull base repair is necessary to prevent the occurrence of CSF leak, especially careful examination in internal auditory meatus, tympanum, eustachian tube and mastoidale.