Jakob Mark, Bertlich Mattis, Eichhorn Klaus W, Thudium Marcus, Bootz Friedrich, Send Thorsten
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Munich, Germany.
Otorhinolaryngology, Head and Neck Surgery, University Hospital Bonn, Germany.
GMS Interdiscip Plast Reconstr Surg DGPW. 2019 Jul 16;8:Doc11. doi: 10.3205/iprs000137. eCollection 2019.
Spontaneous rhinoliquorrhea often occurs due to defects of the skull base. It is often misinterpreted as rhinitis and is surgically the most difficult rhinoliquorrhea entity to close. We conducted a retrospective chart analysis of patients that were diagnosed with spontaneous rhinoliquorrhea at the University Hospital Bonn between 2001 and 2017. Overall, twelve patients were included in this study. On average, the time between occurrence of nasal discharge and diagnoses of rhinoliquorrhea was 123 days. In ten patients, the localization of the skull base defect could be localized by computed tomography or MRI cisternography. Ten patients underwent surgery, of which 9 remained recurrence free. One patient underwent revision surgery and from thereon was recurrence free. Spontaneous rhinoliquorrhea still remains a diagnostic and therapeutic challenge. Whenever persistent watery nasal discharge appears in a patient, rhinoliquorrhea must be considered. Endoscopic surgical reconstruction of the skull base is the therapeutic gold standard and should be attempted as soon as the diagnosis is secured.
自发性脑脊液鼻漏常因颅底缺损而发生。它常被误诊为鼻炎，并且在手术中是最难闭合的脑脊液鼻漏类型。我们对2001年至2017年期间在波恩大学医院被诊断为自发性脑脊液鼻漏的患者进行了回顾性病历分析。总体而言，本研究纳入了12例患者。鼻漏出现至脑脊液鼻漏诊断的平均时间为123天。10例患者的颅底缺损部位可通过计算机断层扫描或磁共振脑池造影确定。10例患者接受了手术，其中9例无复发。1例患者接受了翻修手术，此后无复发。自发性脑脊液鼻漏仍然是一个诊断和治疗挑战。每当患者出现持续性水样鼻漏时，必须考虑脑脊液鼻漏。内镜下颅底手术重建是治疗的金标准，一旦确诊应尽快尝试。
