Millen S J, Meyer G
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee.
Am J Otol. 1993 Nov;14(6):585-9.
Cerebrospinal fluid (CSF) otorhinorrhea continues to be one of the most common complications following surgery for cerebellopontine angle (CPA) tumors. For retrosigmoid approaches, this complication has been reported to occur in 12-19 percent of patients. Nearly all prior surgical attempts at control have included middle ear and eustachian tube obliteration along with packing of the mastoid. This article reviews 165 retrosigmoid procedures (January 1982-December 1990) for removal of CPA tumors, with a leak rate of 9.8 percent (16 cases), 7.2 percent (12 cases) requiring surgical control. An operative technique involving only mastoid obliteration is presented. This approach is less invasive as it limits the scope of the surgical field and also maintains the integrity of the middle ear for potential preservation of hearing. This approach has resulted in control in 100 percent of the patients, without reoperation. The routes of the CSF leak, the technique, and the rationale for its use are presented.
脑脊液耳鼻漏仍然是桥小脑角（CPA）肿瘤手术后最常见的并发症之一。对于乙状窦后入路，据报道该并发症在12%至19%的患者中发生。几乎所有先前控制该并发症的手术尝试都包括中耳和咽鼓管闭塞以及乳突填充。本文回顾了1982年1月至1990年12月期间165例乙状窦后入路切除CPA肿瘤的手术，漏液率为9.8%（16例），其中7.2%（12例）需要手术控制。本文介绍了一种仅涉及乳突闭塞的手术技术。这种方法侵入性较小，因为它限制了手术视野的范围，并且还保持了中耳的完整性，有可能保留听力。这种方法在100%的患者中实现了控制，无需再次手术。本文还介绍了脑脊液漏的途径、技术及其使用原理。
