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CLC number: R764

On-line Access: 2019-01-22

Received: 2018-04-15

Revision Accepted: 2018-08-25

Crosschecked: 2018-12-05

Cited: 0

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Citations:  Bibtex RefMan EndNote GB/T7714


Bing Wang


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Journal of Zhejiang University SCIENCE B 2019 Vol.20 No.2 P.156-163


Cerebrospinal fluid otorrhea secondary to congenital inner ear dysplasia: diagnosis and management of 18 cases

Author(s):  Bing Wang, Wen-jia Dai, Xiao-ting Cheng, Wen-yi Liuyang, Ya-sheng Yuan, Chun-fu Dai, Yi-lai Shu, Bing Chen

Affiliation(s):  ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200030, China; more

Corresponding email(s):   yilai_shu@fudan.edu.cn, bingchen@fudan.edu.cn

Key Words:  Cerebrospinal fluid, Abnormality, High-resolution computed tomography (HRCT), Congenital inner ear dysplasia, Otorrhea, Meningitis

Bing Wang, Wen-jia Dai, Xiao-ting Cheng, Wen-yi Liuyang, Ya-sheng Yuan, Chun-fu Dai, Yi-lai Shu, Bing Chen. Cerebrospinal fluid otorrhea secondary to congenital inner ear dysplasia: diagnosis and management of 18 cases[J]. Journal of Zhejiang University Science B, 2019, 20(2): 156-163.

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author="Bing Wang, Wen-jia Dai, Xiao-ting Cheng, Wen-yi Liuyang, Ya-sheng Yuan, Chun-fu Dai, Yi-lai Shu, Bing Chen",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Cerebrospinal fluid otorrhea secondary to congenital inner ear dysplasia: diagnosis and management of 18 cases
%A Bing Wang
%A Wen-jia Dai
%A Xiao-ting Cheng
%A Wen-yi Liuyang
%A Ya-sheng Yuan
%A Chun-fu Dai
%A Yi-lai Shu
%A Bing Chen
%J Journal of Zhejiang University SCIENCE B
%V 20
%N 2
%P 156-163
%@ 1673-1581
%D 2019
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1800224

T1 - Cerebrospinal fluid otorrhea secondary to congenital inner ear dysplasia: diagnosis and management of 18 cases
A1 - Bing Wang
A1 - Wen-jia Dai
A1 - Xiao-ting Cheng
A1 - Wen-yi Liuyang
A1 - Ya-sheng Yuan
A1 - Chun-fu Dai
A1 - Yi-lai Shu
A1 - Bing Chen
J0 - Journal of Zhejiang University Science B
VL - 20
IS - 2
SP - 156
EP - 163
%@ 1673-1581
Y1 - 2019
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1800224

Objective: To describe the characteristics of the clinical presentation, diagnosis, surgical methods, and outcomes of patients with otogenic cerebrospinal fluid (CSF) leakage secondary to congenital inner ear dysplasia. Methods: A retrospective review was performed of 18 patients with otogenic CSF leakage secondary to inner ear dysplasia who underwent surgery in our group from 2007 to 2017 and had a follow-up of at least 4 months. The average length of follow-up was three years. The characteristics of the clinical presentations of all patients, such as self-reported symptoms, radiographic findings, surgical approaches and methods of repair, position of the leakage during surgery, and postoperative course, including the success rate of surgery, are presented. Results: The patients presented mostly with typical symptoms of meningitis, severe hearing impairment, and CSF otorrhea or rhinorrhea. All 18 patients had at least one previous episode of meningitis accompanied by a severe hearing impairment. The preoperative audiograms of 17 patients showed profound sensorineural hearing loss, and one patient had conductive hearing loss. Twelve patients presented with an initial onset of otorrhea, and two had accompanying rhinorrhea. Six patients complained of rhinorrhea, two of whom were misdiagnosed with CSF rhinorrhea and underwent transnasal endoscopy at another hospital. high-resolution computed tomography (HRCT) images can reveal developments in the inner ear, such as expansion of a vestibular cyst, unclear structure of the semicircular canal or cochlea, or signs of effusion in the middle ear or mastoid, which strongly suggest the possibility of CSF otorrhea. The children in the study suffered more severe dysplasia than adults. All 18 patients had CSF leakage identified during surgery. The most common defect sites were in the stapes footplates (55.6%), and 38.9% of patients had a leak around the oval window. One patient had a return of CSF otorrhea during the postoperative period, which did not re-occur following a second repair. Conclusions: CSF otorrhea due to congenital inner ear dysplasia is more severe in children than in adults. The most common symptoms were meningitis, hearing impairment, and CSF otorrhea or rhinorrhea. HRCT has high diagnostic accuracy for this disease. The most common fistula site was around the oval window, including the stapes footplates and the annular ligament.

18例先天性内耳发育不良继发脑脊液耳漏诊疗 总结



Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


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