Pascal-Vigneron V, Weryha G, Braun M, Morel-Jean J, Bisset S, Leclère J
Clinique Médicale et Endocrinologique, CHU de Nancy-Brabois, Vandoeuvre les Nancy.
Ann Endocrinol (Paris). 1994;54(5):347-51.
Cerebrospinal fluid rhinorrhea and otorrhea are rare complications of conservative and medical management of invasive macroprolactinomas. The slow shrinkage of the tumor during therapy is responsible for delayed rhinorrhea and otorrhea which carry the risk of meningitis. The operative procedure for closure of the fistulae is needed. We report the occurrence of CSF rhinorrhea in two patients with macroprolactinoma who were treated by bromocriptine. In one patient the fistulae is surgically treated and the treatment by bromocriptine is maintained. In the other patient the rhinorrhea is associated with otorrhea and the operation is not required because of the massive destruction of skull base. The CSF rhinorrhea and otorrhea stopped after diminution of bromocriptine doses.
脑脊液鼻漏和耳漏是侵袭性大泌乳素瘤保守治疗和药物治疗罕见的并发症。治疗期间肿瘤缓慢缩小导致脑脊液鼻漏和耳漏延迟出现,而这会带来脑膜炎风险。因此需要进行瘘管闭合手术。我们报告了两名接受溴隐亭治疗的大泌乳素瘤患者发生脑脊液鼻漏的情况。其中一名患者的瘘管接受了手术治疗,同时继续使用溴隐亭治疗。另一名患者的鼻漏伴有耳漏,由于颅底广泛破坏,无需进行手术。减少溴隐亭剂量后,脑脊液鼻漏和耳漏停止。