- 期刊
自發性腦脊髓液耳漏－病例報告
Spontaneous Cerebrospinal Fluid Otorrhea - Case Report
摘要
自發性腦脊髓液耳漏是指在無外傷、感染等原因下，腦脊髓液由耳或鼻流出。此病可分為兩類：一為經迷路之少年型(juvenile onset translabyrinthine type)，是一種先天胚胎之發育異常，常合併有迷路的缺陷，因此病人從小即有嚴重的聽力障礙；另一種為經迷路旁之成年型(adult onset perilabyrinthine type)，為後天發育之異常，但迷路是完好的，故病人原來並無聽力的問題。以上二者皆非常罕見，以後者更甚，近年的國外期刊偶有零星報告。台中榮總耳鼻喉科於1993年3月經歷1例以腦膜炎表現之成年型自發性腦脊髓液耳漏，經乳突切開術及中顱窩路徑(middle cranial fossa approach)加以探查及修補；病人於手術後追蹤6個月，其聽力正常且無復發現象。
並列摘要
Spontaneous cerebrospinal fluid (CSF) otorrhea implies the observation of CSF draining from the ear or nose without any previous hjistory of traumatic or infectious etiology. This disease can be divided into two main categories: one is juvenile onset translabyrinthine type which is a kind of congenital anomaly associated with anacusis and severe labyrinthine dysplasia. The other is adult onset perilabyrinthine type which is one kind of developmental abnomality. The latter does not involve the labyrinth, therefore it usually had normal hearing initially. Both types are rare and the adult type is even rarer. Only a few cases have been reported in the literature. Recently, we encountered a case of adult type of spontaneous CSF otorrhea whose clinical manifestation was meningitis. The bony defect of the tegmen was repaired via mastoidectomy and middle cranial fossa approach. This patient has normal hearing without recurrence after 6 months' follow-up. Spontaneous CSF otorrhea is a rare but potential fatal disease which is frequently misdiagnosed. We presented our experience in this case and reviewed the literature related.