Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Department of Radiology, Medical University of South Carolina, Charleston, South Carolina.
Otol Neurotol. 2023 Oct 1;44(9):896-902. doi: 10.1097/MAO.0000000000003992. Epub 2023 Aug 14.
To compare the presentation and outcomes of patients with and without obstructive eustachian tube dysfunction (oETD) undergoing repair of lateral skull base spontaneous cerebrospinal fluid (sCSF) leaks.
Retrospective chart review.
Tertiary referral center.
Adults with lateral skull base sCSF leaks who underwent repairs from January 1, 2011, to December 31, 2020, were collected.
Comparative statistics and effect sizes were used to compare clinical features, operative findings, and outcomes between groups.
Of 92 ears from 89 patients included, 51.1% (n = 47) had oETD. There were no differences in demographics between patients with and without oETD. Mean age was 60.7 ± 13.1 versus 58.5 ± 12.8 years ( d = -0.17 [-0.58 to 0.24]), mean body mass index was 33.8 ± 8.5 versus 36.0 ± 8.0 kg/m 2 ( d = 0.27 [-0.14 to 0.68]), and female sex preponderance was 59.6% (n = 28) versus 68.8% (n = 31; Φ = -0.09), respectively. There were no differences in the radiologic number, size, and locations of defects. Patients with oETD had less pneumatized mastoids than those without oETD ( p = 0.001; Φ = 0.43). Mean change from preoperative to postoperative air pure-tone average for those with and without oETD was -1.1 ± 12.6 versus 0.1 ± 17.2 dB ( d = 0.09 [-0.04 to 0.58]), respectively. Six ears (6.5%; three with and three without oETD) underwent revisions for rhinorrhea/otorrhea between 5 and 28 months postoperatively, during which four leaks were found, the two patients without leaks had oETD.
The presentation of sCSF leaks and outcomes of repairs in patients with oETD do not differ from those without oETD. Although postoperative otorrhea might represent an inflammatory or infectious process in patients with oETD, reexploration is warranted if patients do not improve with conservative treatment.
比较伴有和不伴有阻塞性咽鼓管功能障碍（oETD）的患者接受外侧颅底自发性脑脊液（sCSF）漏修复的表现和结局。
回顾性图表审查。
三级转诊中心。
2011 年 1 月 1 日至 2020 年 12 月 31 日期间接受外侧颅底 sCSF 漏修复的成年人。
比较组间临床特征、手术发现和结局的统计学数据和效应量。
在纳入的 89 名患者的 92 只耳朵中，51.1%（n=47）有 oETD。伴有和不伴有 oETD 的患者在人口统计学方面无差异。平均年龄分别为 60.7±13.1 岁和 58.5±12.8 岁（d=-0.17[-0.58 至 0.24]），平均体重指数分别为 33.8±8.5 千克/平方米和 36.0±8.0 千克/平方米（d=0.27[-0.14 至 0.68]），女性优势分别为 59.6%（n=28）和 68.8%（n=31；Φ=-0.09）。放射影像学上的缺陷数量、大小和位置无差异。伴有 oETD 的患者比不伴有 oETD 的患者更不易发生气房性乳突（p=0.001；Φ=0.43）。伴有和不伴有 oETD 的患者术前至术后空气纯音平均变化分别为-1.1±12.6 分贝和 0.1±17.2 分贝（d=0.09[-0.04 至 0.58]）。6 只耳朵（6.5%；3 只伴有和 3 只不伴有 oETD）在术后 5 至 28 个月间因鼻漏/耳漏而行翻修，在此期间发现 4 例漏口，2 例无漏口的患者有 oETD。
伴有 oETD 的患者的 sCSF 漏的表现和修复结果与不伴有 oETD 的患者无差异。尽管 oETD 患者的术后耳漏可能代表炎症或感染过程，但如果患者未通过保守治疗得到改善，则需要再次探查。
