Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06520, USA.
Int Forum Allergy Rhinol. 2012 Sep-Oct;2(5):402-4. doi: 10.1002/alr.21048. Epub 2012 May 7.
The purpose of this work was to describe a clinical and radiographic pattern of findings that helps localize the site of spontaneous cerebrospinal fluid (CSF) leaks.
This study was a retrospective review of CSF leaks treated at the University of Texas Southwestern Medical Center from 2000 to 2009. Data collected included demographics, nature of presentation, imaging findings, intraoperative location of skull-base defect, and clinical follow-up.
Forty-six patients' charts were reviewed. Among these patients, 15 did not show a bony skull-base defect on high-resolution computed tomography (CT) scan. They did, however, each show a small area of opacification in the olfactory cleft. In each case, this area of opacification correlated with the site of the CSF leak. Intrathecal fluorescein was not used, except in 2 instances. Successful repair was noted in all patients on follow-up, without evidence of recurrence at the repair site.
In the absence of a clearly identifiable bony skull-base defect, opacification of the olfactory cleft is a localizing sign in some cases of spontaneous CSF rhinorrhea. Such a finding should direct endoscopic repair, and may serve as the only marker for the specific leak site.
本研究旨在描述一种有助于确定自发性脑脊液（CSF）漏部位的临床和影像学表现模式。
这是一项对 2000 年至 2009 年在德克萨斯大学西南医学中心治疗的 CSF 漏患者进行的回顾性研究。收集的数据包括人口统计学资料、表现特征、影像学发现、颅底缺陷的术中位置以及临床随访。
共回顾了 46 例患者的病历。其中 15 例患者的高分辨率计算机断层扫描（CT）未显示骨颅底缺陷，但嗅裂均有一小片混浊。在每种情况下，该混浊区域均与 CSF 漏部位相关。除 2 例外，均未使用鞘内荧光素。在随访中，所有患者的修复均成功，修复部位无复发迹象。
在没有明确可识别的骨颅底缺陷的情况下，嗅裂混浊是自发性 CSF 鼻漏的定位标志。这种发现应指导内镜修复，并可作为特定漏口部位的唯一标志物。
