Martínez-Capoccioni G, Serramito-García R, Huertas-Pardo B, García-Allut A, Martín-Martín C
Service of ENT-Head and Neck Surgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
Service of Neurosurgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
J Laryngol Otol. 2015 Apr;129(4):358-64. doi: 10.1017/S0022215115000584.
This retrospective study aimed to evaluate the effective closure rate for spontaneous cerebrospinal fluid leaks with functional endoscopic sinus surgery and identify patient characteristics that may be associated with a need for additional therapy.
A retrospective analysis of patients with spontaneous cerebrospinal fluid leaks was performed. Data on the nature of presentation, patient body mass index, defect location and size, intracranial pressure, clinical follow up, and complications were collected.
Twenty-five patients had spontaneous cerebrospinal fluid leaks with evidence of idiopathic intracranial hypertension. The most common sites were the cribriform plate, followed by the ethmoid roof and sphenoid lateral pterygoid recess. All patients underwent endonasal endoscopic surgery to repair the defect. Post-operatively, all patients underwent lumbar drainage and acetazolamide therapy.
Spontaneous cerebrospinal fluid leaks represent a surgical challenge because of their high recurrence rates. The most important factor for obtaining a successful repair in these patients is reducing their intracranial pressure through nutritional, medical or surgical means.
本回顾性研究旨在评估功能性鼻内镜鼻窦手术治疗自发性脑脊液漏的有效闭合率，并确定可能与需要额外治疗相关的患者特征。
对自发性脑脊液漏患者进行回顾性分析。收集有关临床表现性质、患者体重指数、缺损位置和大小、颅内压、临床随访及并发症的数据。
25例患者存在自发性脑脊液漏并有特发性颅内高压证据。最常见部位是筛板，其次是筛窦顶和蝶窦外侧翼突隐窝。所有患者均接受鼻内镜手术修复缺损。术后，所有患者均接受腰椎引流和乙酰唑胺治疗。
自发性脑脊液漏因其高复发率而成为手术挑战。在这些患者中获得成功修复的最重要因素是通过营养、药物或手术手段降低颅内压。
