以遲發性腦脊髓液耳漏來表現之外傷後腦脫出－病例報告

Post-traumatic Brain Herniation Presenting as Delayed Cerebrospinal Fluid Otorrhea - Case Report

陳益祥(Yi-Hsiang Chen) ； 吳宗勳(Tzong-Shiun Wu) ； 蘇志英(Chih-Ying Su) ； 盧康(Kang Lu)

《中華民國耳鼻喉科醫學會雜誌》 31卷2期 (1996/04) Pp. 190-194

https://doi.org/10.6286/1996.31.2.190

摘要

頭部外傷引起的腦脊髓液耳漏病不少見，且大多在受傷後就出現。頭部外傷後多年才因鼓室蓋缺損及腦組織脫垂入中耳，而出現突發性腦脊髓液耳漏的病例就很罕見。本文提出一名35歲女性，在頭部外傷13年後，突然出現大量腦脊髓液耳漏，經電腦斷層掃瞄及核磁共振影像檢查，發現鼓室蓋缺損及腦組織脫垂入中耳。手術採中顱窩徑路探查，先切除脫垂的腦組織，然後再以顳肌肌膜及顳肌修補缺損，並以組織膠加以固定。

關鍵字

腦脫出 ； 腦脊髓液耳漏 ； 外傷性

並列摘要

Cerebrospinal fluid (CSF) otorrhea following head trauma is not uncommon. Most traumatic CSF otorrhea appears immediately and ceases spontaneously. Sudden onset of CSF otorrhea owing to brain herniation into the middle ear cavity via a tegmen defect presenting many years following head trauma is rare. The paper reports a 35-year-old female who once had a major head trauma history, and after that, 13 years passed uneventfully. Sudden onset of profuse CSF otorrhea occurred to her. High resolution CT scan and MR imaging revealed a brain tissue herniated into the middle ear via a tegmen defect. Surgical repair was performed via middle cranial fossa approach. The herniated brain tissue was excised first, and the dura defect was repaired with a piece of the temporalis muscle with fascia graft which was fixed there with tissue glue. The post-operative recovery course was well, and up to now, no CSF otorrhea has recurred.

並列關鍵字

brain hernation ； cerebrospinal fluid otorrhea ； traumatic