自发性脑脊液耳漏临床诊治分析

边盼盼;徐百成;仵倩;陈迟;刘贝贝;令娜娜;郭玉芬;

1:兰州大学第二医院耳鼻咽喉科兰州

2:甘肃省卫生健康委员会

摘要
目的探讨自发性脑脊液耳漏的早期临床表现、诊断及手术方法。方法结合文献分析一例4岁儿童(病例1)和一例68岁成人(病例2)自发性脑脊液耳漏患者的临床表现、听力及影像学等检查结果、手术方法及预后。结果病例1表现为反复发作化脓性脑膜炎;影像学检查见中耳低密度影,未见明显骨质缺损;中耳积液检测符合脑脊液;该病例经耳道鼓室入路手术探查发现漏口位于镫骨底板,表现为裂隙样骨质缺损,采用哑铃状肌肉筋膜填塞后修补成功。病例2主要表现为耳闷和听力下降;影像学及中耳积液检查同病例1;经耳道鼓室联合乳突入路手术探查发现漏口位于鼓室天盖,通过多层填塞法修补成功。病例1随访1年、病例2随访6个月均无复发。结论自发性脑脊液耳漏在儿童和成人的临床表现差异大且特异性差,易误诊,可通过影像学及中耳积液的实验室检查辅助诊断;手术是最有效的治疗方法且效果可靠;需综合临床表现及影像学检查后选择合适手术入路。
关键词
自发性脑脊液耳漏;早期诊断;手术方法
基金项目(Foundation):
国家自然科学基金面上项目(8157030324);; 甘肃省卫生行业科研计划项目(GSWSKY2018-40)、甘肃省卫生行业科研计划项目(GSWSKY2017-11)资助
作者
边盼盼;徐百成;仵倩;陈迟;刘贝贝;令娜娜;郭玉芬;
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