Talamonti G, Fontana R A, Versari P P, Villa F, D'Aliberti G A, Car P, Collice M
Department of Neurosurgery, Niguarda Ca'Granda Hospital, Milan, Italy.
Acta Neurochir (Wien). 1995;137(3-4):164-73. doi: 10.1007/BF02187189.
Delayed complications of ethmoid fractures are considered relatively rare. However, meningitis, recurrence of previously ceased cerebrospinal fluid rhinorrhea and delayed onset of cerebrospinal fluid rhinorrhea are possible even years after trauma. We report 10 consecutive patients with delayed complications of ethmoid fractures, whom we treated over the past 11 years. All patients had previously sustained a closed head injury and had remained anosmic. Variously after trauma (ranging from 2 months to 31 years), these patients were re-admitted because of meningitis (6 cases), recurrence of previously ceased cerebrospinal fluid rhinorrhea (3 cases), and delayed onset of cerebrospinal fluid rhinorrhea (1 case). In all cases the delayed complications were associated with relatively large defects of the ethmoid bone. These bone lesions were now evident even in those patients whose radiological assessments had been normal after trauma. All patients underwent a successful surgical repair and remained well during the follow-up. We discuss the possibility that delayed complications of ethmoid fractures are due to a mechanism like that of "growing fractures" in children.
筛骨骨折的延迟并发症被认为相对罕见。然而，即使在创伤数年之后，脑膜炎、先前已停止的脑脊液鼻漏复发以及脑脊液鼻漏延迟发作都是有可能发生的。我们报告了过去11年中连续治疗的10例筛骨骨折延迟并发症患者。所有患者此前均遭受过闭合性颅脑损伤且一直嗅觉丧失。创伤后不同时间（从2个月到31年不等），这些患者因脑膜炎（6例）、先前已停止的脑脊液鼻漏复发（3例）以及脑脊液鼻漏延迟发作（1例）而再次入院。在所有病例中，延迟并发症均与筛骨相对较大的缺损有关。这些骨病变现在在那些创伤后放射学评估正常的患者中也很明显。所有患者均成功接受了手术修复，且在随访期间情况良好。我们讨论了筛骨骨折延迟并发症可能是由于类似于儿童“生长性骨折”的机制所致的可能性。
