-
Abstract: Cerebrospinal fluid (CSF) rhinorrhea is the result of an abnormal communication between sinonasal tract and the subarachnoid space through skull base defect. The etiology of CSF rhinorrhea can be traumatic, iatrogenic, tumor induced and spontaneous. Spontaneous CSF rhinorrhea (SCSFR) occurs in the absence of trauma, surgery, or other inducing events. SCSFR is rarely encountered in daily clinical practice, thus misdiagnosis is common when the clinical symptoms are atypical. SCSFR does not typically self-resolve and requires surgical repair. Timely and effective closure of defects is critical to avoid potentially serious consequences including brain abscess and meningitis. Clinical research indicated an underestimation of SCSFR in the past. Nowadays, with the improvement of diagnostic techniques and clinical awareness, the detection rate of SCSFR has increased. This study conducted a systematic review about the etiology and treatment strategy of SCSFR.
-
Key words:
- cerebrospinal fluid rhinorrhea /
- etiology /
- therapy
-
[1] Wise SK, Schlosser RJ. Evaluation of spontaneous nasal cerebrospinal fluid leaks[J]. Curr Opin Otolaryngol Head Neck Surg, 2018, 15(1): 28-34.
[2] 张璞, 穆俊晌. 颅内压增高与自发性脑脊液鼻漏[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(10): 870-872. doi: 10.3760/cma.j.issn.1673-0860.2015.10.020
[3] Chaaban MR, Illing E, Riley KO, et al. Spontaneous cerebrospinal fluid leak repair: a five-year prospective evaluation[J]. Laryngoscope, 2014, 124(1): 70-75. doi: 10.1002/lary.24160
[4] Rosenfeld E, Dotan G, Kimchi TJ, et al. Spontaneous cerebrospinal fluid otorrhea and rhinorrhea in idiopathic intracranial hypertension patients[J]. J Neuroophthalmol, 2013, 33(2): 113-116. doi: 10.1097/WNO.0b013e18274b870
[5] 朱正洁, 程岚, 杨军, 等. 成人自发性脑脊液鼻漏诊治的临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(6): 457-461.
[6] Soler ZM, Schlosser RJ. Spontaneous cerebrospinal fluid leak and management of intracranial pressure[J]. Adv Otorhinolaryngol, 2013, 74: 92-103.
[7] O'Connell BP, Stevens SM, Xiao CC, et al. Lateral Skull Base Attenuation in Patients with Anterior Cranial Fossa Spontaneous Cerebrospinal Fluid Leaks[J]. Otolaryngol Head Neck Surg, 2016, 154(6): 1138-1144. doi: 10.1177/0194599816630738
[8] Alonso RC, de la Peña MJ, Caicoya AG, et al. Spontaneous Skull Base Meningoencephaloceles and Cerebrospinal Fluid Fistulas[J]. Radiographics, 2013, 33(2): 553-570. doi: 10.1148/rg.332125028
[9] Aaron G, Doyle J, Vaphiades MS, et al. Increased intracranial pressure in spontaneous CSF leak patients is not associated with papilledema[J]. Otolaryngol Head Neck Surg, 2014, 151(6): 1061-1066. doi: 10.1177/0194599814551122
[10] Aaron GP, Illing E, Lambertsen Z, et al. Enlargement of Meckel's cave in patients with spontaneous cerebrospinal fluid leaks[J]. Int Forum Allergy Rhinol, 2016, 7(4): 421-424.
[11] Wang EW, Rd VW, Schlosser RJ. Spontaneous CSF Leaks[J]. Otolaryngol Clin North Am, 2011, 44(4): 845-856. doi: 10.1016/j.otc.2011.06.018
[12] Quatre R, Attye A, Righini C, et al. Spontaneous Cerebrospinal Fluid Rhinorrhea: Association With Body Weight and Imaging Data[J]. J Neurol Surg B Skull Base, 2017, 78(5): 419-424. doi: 10.1055/s-0037-1603731
[13] Friesner D, Rosenman R, Lobb BM, et al. Idiopathic Intracranial Hypertension in the USA: The Role of Obesity in Establishing Prevalence and Healthcare Costs[J]. Obes Rev, 2011, 12(5): e372-e380. doi: 10.1111/j.1467-789X.2010.00799.x
[14] Nelson RF, Roche JP, Gantz BJ, et al. Middle cranial fossa(MCF)approach without the use of lumbar drain for the management of spontaneous cerebral spinal fluid(CSF)leaks[J]. Otol Neurotol, 2016, 37(10): 1625-1629. doi: 10.1097/MAO.0000000000001208
[15] Lobo BC, Baumanis MM, Nelson RF. Surgical repair of spontaneous cerebrospinal fluid(CSF)leaks: A systematic review[J]. Laryngoscope Investig Otolaryngol, 2017, 2(5): 215-224. doi: 10.1002/lio2.75
[16] 孙敬武, 万光伦, 何双八, 等. 自发性脑脊液鼻漏的诊断与治疗[J]. 中国中西医结合耳鼻咽喉科杂志, 2007, 15(3): 186-189. doi: 10.3969/j.issn.1007-4856.2007.03.009
[17] Lloyd KM, Delgaudio JM, Hudgins PA. Imaging of Skull Base Cerebrospinal Fluid Leaks in Adults[J]. Radiology, 2008, 248(3): 725-736. doi: 10.1148/radiol.2483070362
[18] Algin O, Hakyemez B, Gokalp G, et al. The contribution of 3D-CISS and contrast-enhanced MR cisternography in detecting cerebrospinal fluid leak in patients with rhinorrhoea[J]. Br J Radiol, 2010, 83(987): 225-232. doi: 10.1259/bjr/56838652
[19] Seth R, Rajasekaran K, Benninger MS, et al. The utility of intrathecal fluorescein in cerebrospinal fluid leak repair[J]. Otolaryngol Head Neck Surg, 2010, 143(5): 626-632. doi: 10.1016/j.otohns.2010.07.011
[20] Psaltis AJ, Schlosser RJ, Banks CA, et al. A systematic review of the endoscopic repair of cerebrospinal fluid leaks[J]. Otolaryngol Head Neck Surg, 2012, 147(2): 196-203. doi: 10.1177/0194599812451090
[21] Pérez MA, Bialer OY, Bruce BB, et al. Primary spontaneous cerebrospinal fluid leaks and idiopathic intracranial hypertension[J]. J Neuroophthalmol, 2013, 33(4): 330-337. doi: 10.1097/WNO.0b013e318299c292
[22] 于焕新, 李海艳, 刘钢. 自发性脑脊液鼻漏内镜术后复发的相关因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2015, 29(21): 1847-1849.
[23] Teachey W, Grayson J, Cho DY, et al. Intervention for elevated intracranial pressure improves success rate after repair of spontaneous cerebrospinal fluid leaks[J]. Laryngoscope, 2017, 127(9): 2011-2016. doi: 10.1002/lary.26612
[24] Chaaban MR, Illing E, Riley KO, et al. Acetazolamide for high intracranial pressure cerebrospinal fluid leaks[J]. Int Forum Allergy Rhinol, 2013, 3(9): 718-721. doi: 10.1002/alr.21188
[25] Virk JS, Elmiyeh B, Saleh HA. Endoscopic management of cerebrospinal fluid rhinorrhea: The charing cross experience[J]. J Neurol Surg B Skull Base, 2013, 74(2): 61-67. doi: 10.1055/s-0033-1333620
[26] Stangherlin P, Ledeghen S, Scordidis V, et al. Benign intracranial hypertension with recurrent spontaneous cerebrospinal fluid rhinorrhoea treated by laparoscopic gastric banding[J]. Acta Chir Belg, 2008, 108(5): 616-618. doi: 10.1080/00015458.2008.11680302
[27] 赵恒, 杜郭佳, 汪永新, 等. 自发性脑脊液鼻漏的神经内镜治疗体会[J]. 中华神经外科杂志, 2011, 27(8): 832-834. doi: 10.3760/cma.j.issn.1001-2346.2011.08.027
[28] 刘辉, 曾现伟, 林伟, 等. 腰大池-腹腔分流术治疗特发性颅压增高54例报告[J]. 中华神经外科疾病研究杂志, 2015, 14(4): 368-370.
[29] Jiang ZY, McLean C, Perez C, et al. Surgical outcomes and postoperative management in spontaneous cerebrospinal fluid rhinorrhea[J]. J Neurol Surg B Skull Base, 2018, 79(2): 193-199. doi: 10.1055/s-0037-1606306
计量
- 文章访问数: 1498
- PDF下载数: 338
- 施引文献: 0