经外耳道水下耳内镜修复先天性内耳畸形伴脑脊液耳漏1例并文献复习

目的探讨先天性内耳畸形并脑脊液耳漏患者的外科手术治疗方法。方法对1例先天性内耳畸形并伴有脑脊液耳漏患者采用经外耳道径路常规耳内镜鼓室探查再改用水下耳内镜行脑脊液耳漏填塞修补术。结果手术探查见镫骨底板有缺失漏口,用自体脂肪和颞肌及肌筋膜填塞内耳,封闭前庭窗,1次手术修补成功。术后随访5个月未见有脑脊液耳漏及脑膜炎复发。结论采用水下耳内镜修复内耳畸形伴脑脊液耳漏是有优势的手术方式。

Transcanal Underwater Endoscopic Management of Cerebrospinal Fluid Otorrhea Secondary to Congenital Inner Ear Malformation: Case Report And Literature Review

Objective To report a case of congenital inner ear malformations with cerebrospinal fluid otorrhea treated with transcanal underwater endoscopic repair,with literature review.Methods Tympanic exploration via conventional transcanal endoscopic approach was performed in a pediatric patient with congenital inner ear malformations and concurrent cerebrospinal fluid leakage,followed by repair by inner ear packing using the underwater endoscopic technique.Results A defect in the stapes footplate was identified during tympanic exploration.After stapedectomy,the inner ear was plugged with autologous fat and temporalis muscle grafts and the oval window was covered with a layer of fascia using the underwater endoscopic technique.Successful resolution of cerebrospinal fluid otorrhea was achieved with no recurrent cerebrospinal fluid otorrhea or meningitis during the postoperative follow-up of 5 mouths.Conclusions Underwater endoscopic technique has an advantage over conventional endoscopic surgery in management of congenital inner ear malformation with cerebrospiral fluid otorrhea.