鼓膜置管术后脑脊液耳漏：采用多层移植技术的治疗及重要经验回顾
Cerebrospinal fluid otorrhoea following grommet insertion: management using a multi-layered graft technique and an important lesson revisited.
作者信息
Patil S, Trinidade A, Yung M, Donnelly N
机构信息
Department of Otolaryngology, Ipswich Hospital, Ipswich, UK.
出版信息
J Laryngol Otol. 2013 Jan;127(1):70-2. doi: 10.1017/S0022215112002526. Epub 2012 Dec 10.
BACKGROUND
A spontaneous cerebrospinal fluid leak can sometimes only become apparent following grommet insertion and usually represents dehiscence of the tegmen tympani, which is an uncommon condition.
OBJECTIVES
This report aimed to reaffirm the importance of recognising this unusual presentation and outline management options.
CASE REPORT
A 63-year-old man with conductive hearing loss and type B (flat) tympanometry underwent grommet insertion into his left ear, which resulted in cerebrospinal fluid otorrhoea. A defect of the tegmen tympani was found. This was successfully repaired via a transmastoid approach using a multi-layered grafting technique.
CONCLUSION
Dehiscence of the tegmen tympani is uncommon and may only come to light following grommet insertion, which may be problematic for the uninformed otolaryngologist. Education is important to ensure early recognition and appropriate management.
背景
自发性脑脊液漏有时仅在插入鼓膜通气管后才会显现，通常表现为鼓室盖裂开，这是一种罕见的情况。
目的
本报告旨在重申认识这种不寻常表现的重要性，并概述处理方法。
病例报告
一名63岁男性，患有传导性听力损失且鼓室图为B型（平坦型），左耳插入鼓膜通气管后出现脑脊液耳漏。发现鼓室盖有缺损。通过经乳突入路采用多层移植技术成功修复。
结论
鼓室盖裂开并不常见，可能仅在插入鼓膜通气管后才被发现，这对于不知情的耳鼻喉科医生来说可能是个问题。开展相关教育对于确保早期识别和恰当处理很重要。
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