| ObjectiveTo explore the clinical data of spontaneous cerebrospinal fluid otorrhea(SCSFO)by retrospective analysis,including clinical features,biochemical examination,imaging characteristics and so on,and to analyze the clinical efficacy of surgical treatment of spontaneous cerebrospinal fluid otorrhea.MethodsWe reviewed the clinical data and postoperative follow-up data of patients by retrospective analysis,who were admitted to the Department of Otology from July,2005 to November,2018,in Shandong Provincial ENT Hospital Affiliated to Shandong University.All patients included were without the history of chronic otitis media,history of otology surgery,history of cranial trauma,tumor or iatrogenic cerebrospinal fluid otorrhea.tumor or iatrogenic cerebrospinal fluid otorrhea.There are 29 patients in our study.The collected clinical data including gender,age,the side of the ear effusion,disease characteristics,location of fistulas,imaging features,and treatment methods.Excluding the surgical contraindications,all of the 29 patients before the operation were fully aware of the purpose,significance of the following surgery and so on.They all received the operation to repair the fistulas.While the observation after the operation was well without any relevant complications,they were discharged.The follow-up period ranged from 6 months to 13 years,which included recurrence of cerebrospinal fluid otorrhea,related postoperative complications,hearing status and tinnitus.Statistical analysis of the choice of surgical methods,advantages,disadvantages and surgical treatment.ResultsThere were 14 male and 15 female among the 29 follow-up patients.The age of the visited was ranged from 2 to 56 years old,with the median age was 18 years.All patients underwent imaging examinations,and all of them were unilateral;29 patients underwent surgery treatment.Among them,17 patients had a history of intracranial infection,and 8 patients were admitted to hospital with intracranial infection.20 cases of-imaging showed inner ear malformation.Statistical analysis was performed by biochemical examination.There was no significant difference in gender-related spontaneous cerebrospinal fluid otorrhea(P>0.05).The prevalent population was concentrated in children and the middle-age.Preoperative imaging showed 20 cases of inner ear malformation;There was 18 case with transcanal approach,8 case with transmastoid approach and 3 case with a middle fossa craniotomy approach.All the cases of the transmastoid approach surgery that the localization of the fistula occurs in the stapes footplate.Many different materials have been used in the repair of CSF fistulas to comb a long-lasting resurfacing.After the follow-up,all the patients had no recurrence of cerebrospinal fluid otorrhea,2 patients complained that hearing was slightly lower than before surgery,1 patient complained of better postoperative hearing,and 1 patient complained of postoperative ear fullness,which was adapted in about 3 months after surgery;One patient complained of occasional tinnitus after surgery.ConclusionThe incidence of spontaneous cerebrospinal fluid otorrhea is low,and it is prone to intracranial infection.biochemical examination for β2-transferrin and glucose are used to confirm the presence of CSF in the middle ear.A high-resolution computed tomography(CT)of the skull base is the initial radiographic evaluation with the following examination,a magnetic resonance imaging(MRI),which is helpful to evaluate for the presence of an encephalocele and may confirm that the effusion has similar signal characteristics as CSF.Spontaneous cerebrospinal fluid otorrhea should be treated as soon as possible,according to the location of the leakage to choose the appropriate surgical path,a variety of repair materials during surgery can improve the success rate of repairing the fistulas. |
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