Tom L W, Bilaniuk L, Roa R A, Potsic W P
Division of Otolaryngology, Children's Hospital of Philadelphia.
Ear Nose Throat J. 1992 Jul;71(7):287-90.
In any child with recurrent meningitis, the presence of a congenital perilymph fistula must be entertained. All of the patients must have an audiologic assessment, and if a sensorineural loss is demonstrated, CT of the temporal bones should be performed. CT is excellent in identifying malformations within the temporal bones, fistulous tracts, soft tissue densities in the middle ear, and defects in the tegmen tympani. Although MRI may provide superior discrimination of the audiovestibular and facial nerves and cerebellopontine angle, presently it does not offer any distinct advantages over CT in evaluation of the inner ear. When a fistula is suspected, an exploratory tympanotomy is recommended, and any CSF leak is sealed with muscle.
对于任何患有复发性脑膜炎的儿童，都必须考虑先天性外淋巴瘘的存在。所有患者都必须进行听力评估，如果显示有感音神经性听力损失，则应进行颞骨CT检查。CT在识别颞骨内的畸形、瘘管、中耳软组织密度以及鼓室盖缺损方面表现出色。尽管MRI在区分听神经、前庭神经和面神经以及桥小脑角方面可能更具优势，但目前在评估内耳方面，它相对于CT并没有任何明显的优势。当怀疑有瘘管时，建议进行探查性鼓室切开术，并用肌肉封闭任何脑脊液漏。
