NASAL LEAK OF THE CEREBRAL FLUID

DOI
  • KITAYAMA Motoaki
    Department of Otorhinolaryngology, Kanazawa University, School of Medicine
  • KEYAKI Yoichiro
    Department of Otorhinolaryngology, Kanazawa University, School of Medicine

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Other Title
  • 髄液性鼻漏

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Description

A eight year-old boy was first seen in our Clinic in May, 1966. He was involved in traffic accident in April, 1964 sustaining cointusion of the frontal head. Following this accident he had 7 episodes of the suppuative meningitis by Feb. 1966 accompanied by increased dischage of thecerebral fluid (the liquor). with use of anibiotics during each episode, nesal leak of the cerebra lfiuid became less in amount.<BR>Extranasal ethmoid sinus exploration was scheduled because a bone defect was suspecte dpreoperatively. In operation a bone defect was confirmed. The defect, size of index finger tip, involved the lamina cribriformis and tegmentum of the posterior ethmoid sinus, and the cerebra lfluid was found to be leaking through this defect. The defect was closed using bone wax and Aaron alpha (adhesive polymerizer) after the adjacent bone was exposed removing all granulation tissues. In 2 months postoperatively, the patient developed a recurrence of the leak which last edfor a week. It subsided spontaneously. He has been doing well ever since.<BR>It was presumed that the bone defect was closed primarily by bone wax and then reen for cedby the graulation tissue.<BR>The leak of the cerebral fluid, caused by fractured base of the skull, can be epected moreoften, as the traffic accidents tend to in crease.<BR>There are many operative procedures vailable for these patients, but in some cases the simple procedure such as ours is believed to be an operation of choice.<BR>Though neurinomas occuring in the nasal cavity or the pharynx have been reporte dspora-dically, it rerely originates in the middle ear and mastoi dregions.<BR>Our case reported here is 40th in the World and 4th in the Japanese literatures, toour best know le dge.<BR>Patient was a 5-year-old girl, who was brought to our Clinic on January 7, 1967 with right sided facial paralysis and hearing hardness. A tumor involving the external ear canal and mastid was removed. Gross and pathologic findings were ompatible with the facialneurinoma.<BR>Her postoperative course was uneventful.

Journal

  • JIBI INKOKA TEMBO

    JIBI INKOKA TEMBO 10 (3), 295-297,253, 1967

    Society of Oto-rhino-laryngology Tokyo

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