医学
脑脊液
筋膜
磁共振成像
脑脊液漏
纤维蛋白胶
内耳
泄漏
踏板
前庭
外科
解剖
放射科
病理
前庭系统
工程类
环境工程
机械工程
作者
Isha Tyagi,Rajan Syal,Amit Goyal
出处
期刊:Journal of Laryngology and Otology
[Cambridge University Press]
日期:2005-09-01
卷期号:119 (9): 714-718
被引量:41
标识
DOI:10.1258/0022215054797934
摘要
Objective: In children cerebrospinal fluid (CSF) otorhinorrhoea can be due to congenital inner-ear malformations. Cochlear dysplasia associated with a defect in the stapes footplate is usually the cause of the CSF leak. Repair of the CSF leak in these cases is usually done by packing the vestibule with muscle or fascia. This traditional method of repair has a 30 to 60 per cent failure rate. Material and methods: CSF otorhinorrhoea due to congenital inner-ear anomalies in four patients was repaired using multiple-layer packing of the vestibule with glue, muscle and fascia, reinforced by a pedicle temporalis muscle graft. Intra-operatively, continous lumbar drainage wasperformed. Results: Repair of the CSF leak was successful in four cases and no recurrence was noticed. Inner-ear magnetic resonance imaging (MRI) using three-dimensional fast-spin echo (3D FSE) T2-weighted imaging (T2WI) and 3D steady-state free precession (FIESTA) sequences was found to be a very helpful, noninvasive investigation to localize the site and route of the CSF leak. Conclusions: Children presenting with recurrent meningitis and CSF rhinorrhoea should be investigated for congenital inner-ear anomalies. In these cases CSF fistulae should be repaired using fibrin or cyanoacrylate glue and intra-operative continuous lumbar drainage; 3D FSE T2WI and 3D FIESTA MRI sequences of the inner ear are helpful.
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