Durairaj Vikram D, Andrews Bradley, Rao Rumya R, Chan Kenny H
Department of Ophthalmology, University of Colorado Health Sciences Center, Denver, Colorado 80045-0510, USA.
Orbit. 2008;27(1):51-4. doi: 10.1080/01676830601174718.
To report two cases of otitic hydrocephalus with long-term complications.
Retrospective case reports.
Two patients with otitic hydrocephalus with previously diagnosed otitis media.
Review of clinical history, radiographic findings, medical and surgical management, and follow-up.
Two patients with previously diagnosed otitis media presented with otitic hydrocephalus. Both were found to have elevated opening pressures with lumbar puncture and radiographic evidence of sinus thrombosis. Although the patients received appropriate medical and surgical management, they both suffered long-term complications. Patient 1 is dependent on a ventriculoperitoneal shunt to control headaches and has required multiple shunt revisions. Patient 2 is dependent on a ventriculoperitoneal shunt to control headaches and has permanent decreased visual acuity and bilateral optic neuropathy. During her clinical course, she required an optic nerve sheath fenestration.
Otitic hydrocephalus can result in permanent vision loss and chronic headaches requiring spinal fluid diversion. We report two cases with morbid complications. A collaborative effort from ophthalmologists, otolaryngologists, and neurosurgeons is recommended to achieve the best clinical outcome.
报告两例伴有长期并发症的耳源性脑积水病例。
回顾性病例报告。
两名先前被诊断患有中耳炎的耳源性脑积水患者。
回顾临床病史、影像学检查结果、药物及手术治疗情况以及随访情况。
两名先前被诊断患有中耳炎的患者出现了耳源性脑积水。经腰椎穿刺发现两人的初压均升高，并有鼻窦血栓形成的影像学证据。尽管患者接受了适当的药物及手术治疗，但两人均出现了长期并发症。患者1依赖脑室腹腔分流术来控制头痛，并且需要多次进行分流器翻修。患者2依赖脑室腹腔分流术来控制头痛，视力永久性下降且患有双侧视神经病变。在其病程中，她需要进行视神经鞘开窗术。
耳源性脑积水可导致永久性视力丧失和慢性头痛，需要进行脑脊液分流。我们报告了两例伴有严重并发症的病例。建议眼科医生、耳鼻喉科医生和神经外科医生共同努力以获得最佳临床疗效。
