Magliulo G, Sepe C, Varacalli S, Fusconi M
ENT Clinic, University La Sapienza, Roma, Italy.
J Otolaryngol. 1998 Oct;27(5):258-62.
Postoperative cerebrospinal fluid leak (CSF) is a serious complication of the cerebellopontine angle surgery. In the current literature, CSF leak rates vary from 8.1 to 20%. The various options in managing this troublesome complication include conservative treatment or invasive surgical repair. The focus of this report is to retrospectively analyze our experience on this specific topic reviewing the incidence of CSF leak and the outcomes of its treatment in a group of patients who underwent surgery for different pathology of the cerebellopontine angle.
Eighty-five patients who underwent primary surgical procedures performed by a single neurologist were selected for this study. There were 70 surgical removals of acoustic neuromas, and 15 other cerebellopontine lesions.
The overall incidence of CSF leak in the total group analyzed was 17.6%. There were five CSF rhinorrheas and 10 wound CSF leaks. Ten acoustic neuromas and five other cerebellopontine angle lesions exhibited this complication. The leak was cured in 53.3% of the cases using a continuous lumbar cerebrospinal fluid drainage (CLCFD). In two patients, the leak was treated with an extradural repair.
Although CLCFD is not routinely used in the treatment of the CSF leak, it proved to be an efficacious and safe option, confirmed by no meningitis observed in our patients treated with this method.
术后脑脊液漏是桥小脑角手术的一种严重并发症。在当前文献中，脑脊液漏发生率从8.1%至20%不等。处理这一棘手并发症的各种选择包括保守治疗或侵入性手术修复。本报告的重点是回顾性分析我们在这一特定主题上的经验，回顾一组因桥小脑角不同病变接受手术的患者脑脊液漏的发生率及其治疗结果。
本研究选取了由一位神经科医生进行初次手术的85例患者。其中70例为听神经瘤手术切除，15例为其他桥小脑角病变手术。
在分析的全部患者中，脑脊液漏的总体发生率为17.6%。有5例脑脊液鼻漏和10例伤口脑脊液漏。10例听神经瘤和5例其他桥小脑角病变出现了这种并发症。53.3%的病例通过持续腰椎脑脊液引流（CLCFD）治愈了脑脊液漏。2例患者的脑脊液漏采用硬膜外修补术治疗。
虽然CLCFD并非常规用于治疗脑脊液漏，但事实证明它是一种有效且安全的选择，我们采用这种方法治疗的患者未观察到脑膜炎，证实了这一点。
