Harris H H
Laryngoscope. 1978 Oct;88(10):1577-85. doi: 10.1288/00005537-197810000-00002.
Recurrent attacks of meningitis occurring independent of a systemic bacterial infection should be considered as a cerebrospinal leak either otorrhea or rhinorrhea. Three cases each with a different cause were diagnosed chiefly on the basis of the history and a bulging noninflammatory eardrum. Subsequent use of fluorescein intrathecally not only helped to confirm the diagnosis but was very useful at surgery in locating the leak in the dura of the oval window of the ear. Many materials have been used but autogenous temporal fascia or fascia lata seemed to be most effective in these cases. The sandwiching of the dura between two pieces of fascia is not only realistic but was found to be very effective. One piece of fascia between the arachnoid and dura and another between the dura and bone give a tight seal.
独立于全身性细菌感染而反复发生的脑膜炎应被视为脑脊液漏，即耳漏或鼻漏。主要根据病史和鼓膜膨出但无炎症表现诊断出三例病因各异的病例。随后鞘内使用荧光素不仅有助于确诊，而且在手术中对定位耳部卵圆窗硬脑膜处的漏口非常有用。已使用过多种材料，但自体颞筋膜或阔筋膜在这些病例中似乎最为有效。将硬脑膜夹在两片筋膜之间不仅可行，而且被发现非常有效。在蛛网膜和硬脑膜之间夹一片筋膜，在硬脑膜和骨之间夹另一片筋膜可形成紧密密封。
