Hashimoto T, Manaka S, Nawata H
No Shinkei Geka. 1976 Feb;4(2):197-201.
A 5-year-old girl was admitted to our hopsital on June, 1972, because of meningitis and CSF otorrhea. She had not suffered from head trauma or otological infective disease. Right temporal craniotomy was carried out on October, 1972, but no pathological findings on the anterior surface of the petrous bone was detected, so, the right middle ear bottom was packed with fascia graft by otologist, which stopped the CSF otorrhea for seven months. But the otorrhea recurred on June, 1973, when she caught cold. She was readmitted to our hospital because of recurrent meningitis. On November 7, 1973, when the meningitis abated, posterior fossa exploration was performed microsurgically. Strong arachnoid adhesion due to recurrent meningitis and enlargement of the right internal auditory meatus was observed. Probe could be inserted into the internal auditory meatus easily at a depth of 1.5 cm. Saline which was injected into the meatus from the probe flowed into the right middle ear. So the internal auditory meatus was packed with Gelfoam and muscle piece. By means of this procedure, CSF otorrhea was healed completely. Spontaneous CSF otorrhea, which was initially reported in 1897 by Escat, is a very rare disease. Only 15 cases have been reported in the literature. Two main possible routes of CSF leakage were reported, the one is via the internal auditory meatus, the other is via the cochlear aqueduct (Fig. 3). The former cases were more frequent than the latter. Our case belongs to the former type. (Fig. 4)
一名5岁女孩于1972年6月因脑膜炎和脑脊液耳漏入住我院。她未曾遭受头部外伤或耳部感染性疾病。1972年10月进行了右侧颞骨开颅手术，但在岩骨前表面未发现病理改变，因此，耳鼻喉科医生用筋膜移植物填充了右中耳底部，脑脊液耳漏停止了7个月。但1973年6月她感冒时耳漏复发。因复发性脑膜炎她再次入住我院。1973年11月7日，脑膜炎缓解后，进行了后颅窝显微探查。观察到因复发性脑膜炎导致的强烈蛛网膜粘连和右内耳道扩大。探针可轻松插入内耳道，深度达1.5厘米。从探针注入内耳道的盐水流入右中耳。于是用明胶海绵和肌肉块填充了内耳道。通过该手术，脑脊液耳漏完全治愈。自发性脑脊液耳漏最初由埃卡特于1897年报道，是一种非常罕见的疾病。文献中仅报道了15例。报道了脑脊液漏的两种主要可能途径，一种是通过内耳道，另一种是通过蜗水管（图3）。前者比后者更常见。我们的病例属于前者类型。（图4）
