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自发性脑脊液鼻漏与匹配对照的前颅底厚度比较横断面前瞻性研究

Comparative Cross Sectional Prospective Study of Anterior Skull Base Thickness in Spontaneous Cerebrospinal Fluid Rhinorrhoea vs Matched Controls.

作者信息

Dhanapal Pradeep, Palanisamy Thirunavukarasu, Saravanam Prasanna Kumar, Lakshmanan Somu, Venkataraman Lekhya

机构信息

Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3840-3844. doi: 10.1007/s12070-024-04718-4. Epub 2024 May 15.

Abstract

Cerebrospinal fluid (Csf) leak is the leakage of CSF from subarachnoid space into the nasal cavity.Csf rhinorrhoea is classified as traumatic and non traumatic causes (Ommaya et al. J Neurol Neurosurg Psychiatry 31(3):214, 1968). Spontaneous csf leaks occur due to increased intracranial pressure. Early diagnosis of spontaneous csf leaks may prevent complications like meningitis. This was a cross sectional prospective study done in a tertiary care hospital. Group A-spontaneous csf leak patients and Group B- Non csf leak matched controls. The anterior skull base thickness from fovea ethmoidalis, cribriform plate and lateral lamella were compared between the groups using high resolution computed tomography of paranasal sinus with 2 mm cuts. The anterior skull base thickness was measured by a senior radiologist in our tertiary centre. In this study, total of forty six patients were included, twentythree in each group. The Mean age in Group A and Group B was 48.95 and 48.78 respectively. Body mass index (BMI) was compared between the two groupsand spontaneous csf leak patients had higher value than non csf leak controls. The mean anterior skull base thickness of Group A (cribriform plate-0.56 mm, lateral lamella-0.66 mm, Fovea ethmoidalis-0.91 mm) was lower than Group B (cribriform plate-0.86 mm, lateral lamella-0.84 mm, Fovea ethmoidalis-0.97 mm) which was statistically significant ( value-< 0.05).

摘要

脑脊液(CSF)漏是指脑脊液从蛛网膜下腔漏入鼻腔。脑脊液鼻漏可分为创伤性和非创伤性原因(奥马亚等人,《神经病学、神经外科学与精神病学杂志》31(3):214, 1968)。自发性脑脊液漏是由于颅内压升高引起的。早期诊断自发性脑脊液漏可预防脑膜炎等并发症。这是在一家三级护理医院进行的横断面前瞻性研究。A组为自发性脑脊液漏患者,B组为非脑脊液漏匹配对照。使用鼻窦高分辨率计算机断层扫描(层厚2毫米)比较两组之间筛窦凹、筛板和外侧板的前颅底厚度。前颅底厚度由我们三级中心的一位资深放射科医生测量。在本研究中,共纳入46例患者,每组23例。A组和B组的平均年龄分别为48.95岁和48.78岁。比较两组的体重指数(BMI),自发性脑脊液漏患者的值高于非脑脊液漏对照组。A组的平均前颅底厚度(筛板-0.56毫米,外侧板-0.66毫米,筛窦凹-0.91毫米)低于B组(筛板-0.86毫米,外侧板-0.84毫米,筛窦凹-0.97毫米),差异具有统计学意义(值<0.05)。

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