Massoud Vicky A, Fay Aaron, Yoon Michael K
Department of Ophthalmology, Harvard Medical School , Boston, Massachusetts , USA and.
Semin Ophthalmol. 2014 Sep-Nov;29(5-6):440-9. doi: 10.3109/08820538.2014.959187.
Cerebrospinal fluid leak is a rare, but potentially morbid complication of orbital surgery. In this review, we analyze the reported cases of CSF leak in such surgeries, determine their causes, clinical presentations and sequellae, and highlight the different methods to detect and manage them.
A comprehensive literature review was conducted in PubMed.
Twenty-one cases of CSF leak occurred with orbital exenteration, 34 with orbital decompression, four with DCR, two with enucleation, and four cases with other skull base surgery. Operating in high-risk areas increased the risk of dural injury. Once detected, CSF leak was either controlled by bed rest and head elevation or required a surgical repair. The various techniques of surgical management are discussed.
The number of reported surgical CSF leaks in the orbit is relatively low. To prevent this complication, it is essential to have intimate knowledge of orbital anatomy, especially in the setting of pre-existing abnormalities. If CSF leak occurs, it should be rapidly recognized and adequately managed to prevent further morbidity.
脑脊液漏是眼眶手术中一种罕见但可能引发严重疾病的并发症。在本综述中，我们分析了此类手术中报告的脑脊液漏病例，确定其病因、临床表现和后遗症，并重点介绍检测和处理它们的不同方法。
在PubMed上进行了全面的文献综述。
眼眶内容剜出术中发生21例脑脊液漏，眼眶减压术中发生34例，泪囊鼻腔吻合术中发生4例，眼球摘除术中发生2例，其他颅底手术中发生4例。在高危区域进行手术会增加硬脑膜损伤的风险。一旦发现脑脊液漏，可通过卧床休息和抬高头部来控制，或需要进行手术修复。讨论了手术处理的各种技术。
报告的眼眶手术中脑脊液漏的数量相对较少。为预防这种并发症，必须深入了解眼眶解剖结构，尤其是在存在既往异常的情况下。如果发生脑脊液漏，应迅速识别并进行适当处理，以防止进一步的发病。
