Leonetti J, Anderson D, Marzo S, Moynihan G
Department of Otolaryngology-Head and Neck Surgery at the Loyola Center for Cranial Base Surgery, Maywood, Illinois 60153, USA.
Otolaryngol Head Neck Surg. 2001 May;124(5):511-4. doi: 10.1067/mhn.2001.115089.
The purpose of this article is to outline our methods for the prevention and management of cerebrospinal fluid (CSF) leak after transtemporal skull base surgery.
A total of 589 patients underwent a variety of transtemporal surgical approaches for the extirpation of skull base tumors at our institution from July 1988 to October 1999. The medical records were retrospectively reviewed to identify the tumor histology, size, and location as well as the surgical approach, defect reconstruction technique, and the incidence of postoperative CSF leak.
The risk of CSF fistulae was greatest in utilizing the restrosigmoid approach (8%) and least in those who underwent a translabyrinthine approach (4%). Tumor size had no bearing on the incidence of the CSF leak and the overall incidence of meningitis was 1.0%.
The proper surgical technique will minimize the risk of CSF leak after transtemporal skull base surgery. Immediate management of CSF fistulae helped prevent meningitis in the majority of these patients.
本文旨在概述我们在经颞部颅底手术后预防和处理脑脊液漏的方法。
1988年7月至1999年10月期间，共有589例患者在我院接受了各种经颞部手术入路以切除颅底肿瘤。对病历进行回顾性分析，以确定肿瘤的组织学类型、大小和位置，以及手术入路、缺损修复技术和术后脑脊液漏的发生率。
采用乙状窦后入路时脑脊液漏的风险最高（8%），而采用迷路入路的患者风险最低（4%）。肿瘤大小与脑脊液漏的发生率无关，脑膜炎的总体发生率为1.0%。
正确的手术技术将使经颞部颅底手术后脑脊液漏的风险降至最低。对脑脊液漏的及时处理有助于在大多数此类患者中预防脑膜炎。
