Management and Outcomes of Spontaneous Cerebrospinal Fluid Otorrhoea.

Autor:	Thomeer HG; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.; Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands., Schreurs C; Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands., van Doormaal TP; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.; Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, Netherlands., Straatman LV; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands.; Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
Jazyk:	angličtina
Zdroj:	Frontiers in surgery [Front Surg] 2020 Apr 21; Vol. 7, pp. 21. Date of Electronic Publication: 2020 Apr 21 (Print Publication: 2020).
DOI:	10.3389/fsurg.2020.00021
Abstrakt:	Objective: A cohort of patients with spontaneous cerebrospinal fluid (sCSF) otorrhoea. To report surgical outcome and discuss a treatment protocol. Materials and Methods: Between 2012 and 2018 all patients presenting with sCSF were collected and data assessment was performed including clinical symptoms (hearing loss, aural fullness, meningitis, recurrent otitis media), preoperative audiometry, CT and MRI scanning. According to the site and size of the dural defect, different surgical approaches were applied. Results: A total of 12 patients (14 operations) were included. Four of these had a history of meningitis. All beta-trace protein testings were positive. These patients were treated with different surgical approaches: middle fossa approach (MCF, seven patients), transmastoid approach (TMA) with bony obliteration of the cavity (three patients), and four patients underwent a subtotal petrosectomy (STP) procedure. Three cases underwent revision surgery (MCF or STP) due to residual disease (CFS leakage). After follow up duration of 13 months (6.5 months SD), no recurrence was observed. No severe adverse events such as cerebrovascular injury, meningitis, wound infection, or headache was observed in the postoperative course. Conclusion: Spontaneous aural cerebrospinal fluid leakage is a rare but manageable pathology with potential severe complications. Appropriate diagnosis, laboratory testing, and imaging is primordial to obtain optimal patient outcome. (Copyright © 2020 Thomeer, Schreurs, van Doormaal and Straatman.)
Databáze:	MEDLINE
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