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[外伤性耳漏。50例手术治疗患者(作者译)]

[Traumatic otoliquorrhoea. Fifty patients treated surgically (author's transl)].

作者信息

Bousquet C, Vaneecloo F M, Julliot J P, Piquet J J, Christiaens J L, Lainé E

出版信息

Neurochirurgie. 1980;26(6):369-75.

PMID:7301007
Abstract

After a fracture in the petrous bone responsible for CSF otorrhea, the discharge continues no more than a few days and ceases spontaneously, but if prolonged, meningitis becomes a considerable risk. During the past five years, we operated on 50 cases of cerebral spinal fluid otorrheas after head injury. The surgical procedures were settled after an agreement between neurosurgeons, oto-rhino-laryngologists and neuroradiologists. 6 patients had a neurosurgical approach because of an associated brain lesion, 32 patients were operated only by otologists, 12 patients had presented an early or late meningitis. In most cases (41/50) a microsurgical exploration of the middle ear was performed: CSF was seen to be coming through the internal meatus acusticus into the middle ear, on account of a fracture, a luxation or a disinsertion of the annular ligament of the stirrup bone. The closing of the gap with muscle tissue, from the temporalis, gave good results, without recurrence of otorrhea or meningitis. This procedure may be performed easily and rapidly as soon as the CSF discharge does not cease after few days. This attitude, even if considered as preventive, is safer for the patient.

摘要

在导致脑脊液耳漏的岩骨骨折后,漏液持续不超过几天便会自行停止,但如果持续时间延长,脑膜炎的风险就会大大增加。在过去五年中,我们对50例头部受伤后发生脑脊液耳漏的患者进行了手术。手术方案是在神经外科医生、耳鼻喉科医生和神经放射科医生协商后确定的。6例患者因伴有脑部病变而采用神经外科手术方法,32例患者仅由耳科医生进行手术,12例患者出现了早期或晚期脑膜炎。在大多数病例(50例中的41例)中,对中耳进行了显微外科探查:由于骨折、镫骨脱位或镫骨环状韧带离断,可见脑脊液通过内耳道进入中耳。用颞肌的肌肉组织封闭间隙,效果良好,耳漏和脑膜炎均未复发。一旦脑脊液漏液在几天后仍未停止,该手术可轻松快速地进行。这种做法即使被视为预防性措施,对患者来说也更安全。

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