Stevens Shawn M, Rizk Habib G, Golnik Karl, Andaluz Norberto, Samy Ravi N, Meyer Ted A, Lambert Paul R
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Laryngoscope. 2018 Jan;128(1):248-256. doi: 10.1002/lary.26581. Epub 2017 Mar 27.
Primary literature review, Centers for Disease Control and Prevention website, International Classification of Headache Disorders, Second Edition.
A comprehensive review of the primary literature was performed from 1990 to 2016 utilizing keywords idiopathic intracranial hypertension, pseudotumor cerebri, benign intracranial hypertension, spontaneous cerebrospinal fluid leak, and encephalocele. Articles were included at the discretion of the authors based on novel and/or historical contributions to the literature.
The incidence of idiopathic intracranial hypertension is increasing along with the obesity epidemic. Undiagnosed patients may present to otolaryngologists with pulsatile tinnitus, dizziness, sleep apnea, and spontaneous cerebrospinal fluid leaks. Although diagnosis is predicated upon imaging findings and lumbar puncture, radiographic signs including empty sella, optic nerve dilation, and globe flattening may suggest the diagnosis. The most effective intervention is weight loss combined with acetazolamide. Surgery is reserved for severe or refractory symptoms and can be highly morbid. Otolaryngologists are increasingly responsible for managing a number of secondary disorders including cerebrospinal fluid rhinorrhea and otorrhea. Failure to manage intracranial hypertension may lead to adverse surgical outcomes.
The knowledge base for idiopathic intracranial hypertension has greatly expanded over the past 25 years. This disease is associated with a number of conditions directly relevant to otolaryngologists. A keen understanding of this disorder and its management may optimize outcomes in a growing number of patients. Laryngoscope, 128:248-256, 2018.
1）回顾特发性颅内高压的病理生理学、诊断和治疗方面的争议。2）讨论耳鼻喉科医生在管理该疾病及相关病症中不断演变的作用。
主要文献综述、疾病控制与预防中心网站、《国际头痛疾病分类》第二版。
利用关键词“特发性颅内高压”“假性脑瘤”“良性颅内高压”“自发性脑脊液漏”和“脑膨出”，对1990年至2016年的主要文献进行全面综述。作者根据文献中的新颖和/或历史贡献自行决定纳入文章。
随着肥胖症流行，特发性颅内高压的发病率在上升。未被诊断的患者可能因搏动性耳鸣、头晕、睡眠呼吸暂停和自发性脑脊液漏而就诊于耳鼻喉科医生。尽管诊断基于影像学检查结果和腰椎穿刺，但包括空蝶鞍、视神经扩张和眼球扁平在内的影像学征象可能提示诊断。最有效的干预措施是减重联合乙酰唑胺。手术仅用于严重或难治性症状，且可能具有较高的致残性。耳鼻喉科医生在管理包括脑脊液鼻漏和耳漏在内的多种继发性病症方面的责任越来越大。未能控制颅内高压可能导致不良手术结果。
在过去25年中，特发性颅内高压的知识库有了很大扩展。这种疾病与许多与耳鼻喉科医生直接相关的病症有关。对这种疾病及其管理的深入了解可能会使越来越多患者的治疗效果达到最佳。《喉镜》，2018年，第128卷：248 - 256页。
