Department of Otolaryngology-Head and Neck Surgery, Division of Neurosciences, Stritch School of Medicine, Loyola University Hospital, Maywood, IL 60153, USA.
Int Forum Allergy Rhinol. 2012 May-Jun;2(3):222-6. doi: 10.1002/alr.21023. Epub 2012 Feb 16.
Lumbar drain (LD) use in the management of cerebrospinal fluid (CSF) rhinorrhea remains controversial. We analyzed the relationship between LD placement and CSF leak recurrence after endoscopic repair.
A retrospective case series was conducted. Patients who underwent CSF leak repair from 1999 to 2010 were identified. Data collected included demographics, body mass index (BMI), history of obstructive sleep apnea (OSA) or idiopathic intracranial hypertension (IIH), associated meningoencephalocele, etiology and site of leak, LD placement, fluorescein and antibiotic use, recurrence, and site of recurrence. Correlation between LD placement and leak recurrence was analyzed.
A total of 105 patients underwent CSF leak repair. A total of 68 patients had an LD. Of these 68 patients, 15 (22%) had a recurrent leak. Of the 105 patients, 37 did not have an LD, and 5 of the 37 (14%) recurred. Recurrence rates with and without LD were not significantly different (p = 0.15). Of the 105 patients, 40 (38%) had a spontaneous leak, 15 (14%) had a traumatic leak, and 50 (48%) had an iatrogenic leak. In the spontaneous group, 30 of 40 patients had an LD and 10 of 40 did not. Recurrence was not significant between these subgroups (p = 1.0). LD was used in 11 of 15 patients with traumatic leaks. Of these 15 patients, 4 did not have a drain. Recurrence was not significant between these subgroups (p = 1.0). In 27 of 50 patients with an iatrogenic leak, an LD was placed. Of 50 patients, 23 did not have an LD. There was no statistical significance when the recurrence rates for these subgroups were compared (p = 0.26).
In our study, there was no association identified between LD placement and recurrence rates after endoscopic repair of CSF rhinorrhea.
腰椎引流（LD）在管理脑脊液（CSF）鼻漏中的应用仍存在争议。我们分析了 LD 放置与内镜修复后 CSF 漏复发之间的关系。
进行了一项回顾性病例系列研究。确定了 1999 年至 2010 年间接受 CSF 漏修复的患者。收集的数据包括人口统计学、体重指数（BMI）、阻塞性睡眠呼吸暂停（OSA）或特发性颅内高压（IIH）病史、相关脑膜脑膨出、漏的病因和部位、LD 放置、荧光素和抗生素的使用、复发和复发部位。分析 LD 放置与漏复发之间的相关性。
共 105 例患者接受 CSF 漏修复。共 68 例患者放置了 LD。这 68 例患者中，有 15 例（22%）出现复发性漏。在 105 例患者中，有 37 例未放置 LD，其中 5 例（14%）复发。有和没有 LD 的复发率没有显著差异（p=0.15）。在 105 例患者中，有 40 例（38%）为自发性漏，15 例（14%）为创伤性漏，50 例（48%）为医源性漏。在自发性漏组中，有 40 例患者中的 30 例放置了 LD，而有 40 例患者中的 10 例未放置 LD。这些亚组之间的复发没有显著差异（p=1.0）。15 例创伤性漏患者中有 11 例使用了 LD。在这 15 例患者中，有 4 例未放置引流管。这些亚组之间的复发没有显著差异（p=1.0）。在 50 例医源性漏患者中，有 27 例放置了 LD，有 50 例患者未放置 LD。当比较这些亚组的复发率时，没有统计学意义（p=0.26）。
在我们的研究中，在经内镜修复 CSF 鼻漏后，LD 放置与复发率之间没有关联。
