Posttravmatik beyin omurilik sıvısı fistüllerine yaklaşım
Yükleniyor...
Tarih
1999
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Posttraumatic Cerebrospinal Fistulas (PBF) are serious complications of head trauma which may cause to morbidity and mortality. Usually, they present with rhinorrhea or otorrhea, and they occur acutely in the first week after the trauma, rarely months and years later. In this retrospective study, from 2850 patients suffered head trauma, 48 (% 0.16) of them had PBF. The most frequent etiology was traffic accident in 34 (% 70) cases. Fifteen (%31.5) of all cases had temporal bone fracture; 8 of them had also petrous bone fracture, 31 (% 64.5) cases had parietal bone fracture; 12 of them had also ethmoid bone fracture, 2 (% 4.1) cases had fronto-parietal open depression fracture, also with fracture in the anterior fossa and the ethmoid bone. Rhinorrhea was encountered in 35 (% 73) cases, and otorrhea in 13 (% 27) cases. All patients, except four of them, admitted in 48 hours after the trauma (acute). Ten patients were treated surgically who were unresponded to the conservative treatment. Bifrontal craniotomy with extradural and/or intradural anterior fossa eksploration was performed. Primer repair could be achieved only in one case, eight cases were treated with galea greft, one case with fascia lata greft. Additionally, 8 cases needed the use of fibrin glue, and one case siyanoacrilate. The success of surgical treatment was 100%, and no postoperative fistul formation was observed. Two cases had meningitis on admission. During hospital stay, any case in this series developed meningitis. All patients were treated with prophylactic two combinations antibiotic therapy. For the precise evaluation of PBF, the efficacy of the conservative treatment and prophylactic antibiotic therapy, surgical indications of resistant cases, and appropriate surgical treatment was discussed with literature review.
Posttraumatic Cerebrospinal Fistulas (PBF) are serious complications of head trauma which may cause to morbidity and mortality. Usually, they present with rhinorrhea or otorrhea, and they occur acutely in the first week after the trauma, rarely months and years later. In this retrospective study, from 2850 patients suffered head trauma, 48 (% 0.16) of them had PBF. The most frequent etiology was traffic accident in 34 (% 70) cases. Fifteen (X31.5) of all cases had temporal bone fracture; 8 of them had also petrous bone fracture, 31 (% 64.5) cases had parietal bone fracture; 12 of them had also ethmoid bone fracture, 2 (% 4.1) cases had fronto-parietal open depression fracture, also with fracture in the anterior fossa and the ethmoid bone. Rhinorrhea was encountered in 35 (% 73) cases, and otorrhea in 13 (% 27) cases. All patients, except four of them, admitted in 48 hours after the trauma (acute). Ten patients were treated surgically who were unresponded to the conservative treatment. Bifrontal craniotomy with extradural and/or intradural anterior fossa eksploration was performed. Primer repair could be achieved only in one case, eight cases were treated with galea greft, one case with fascia lata greft. Additionally, 8 cases needed the use of fibrin glue, and one case siyanoacrilate. The success of surgical treatment was 100%, and no postoperative fistulformation was observed. Two cases had meningitis on admission. During hospital stay, any case in this series developed meningitis. All patients were treated with prophylactic two combinations antibiotic therapy. For the precise evaluation of PBF, the efficacy of the conservative treatment and prophylactic antibiotic therapy, surgical indications of resistant cases, and appropriate surgical treatment was discussed with literature review.
Posttraumatic Cerebrospinal Fistulas (PBF) are serious complications of head trauma which may cause to morbidity and mortality. Usually, they present with rhinorrhea or otorrhea, and they occur acutely in the first week after the trauma, rarely months and years later. In this retrospective study, from 2850 patients suffered head trauma, 48 (% 0.16) of them had PBF. The most frequent etiology was traffic accident in 34 (% 70) cases. Fifteen (X31.5) of all cases had temporal bone fracture; 8 of them had also petrous bone fracture, 31 (% 64.5) cases had parietal bone fracture; 12 of them had also ethmoid bone fracture, 2 (% 4.1) cases had fronto-parietal open depression fracture, also with fracture in the anterior fossa and the ethmoid bone. Rhinorrhea was encountered in 35 (% 73) cases, and otorrhea in 13 (% 27) cases. All patients, except four of them, admitted in 48 hours after the trauma (acute). Ten patients were treated surgically who were unresponded to the conservative treatment. Bifrontal craniotomy with extradural and/or intradural anterior fossa eksploration was performed. Primer repair could be achieved only in one case, eight cases were treated with galea greft, one case with fascia lata greft. Additionally, 8 cases needed the use of fibrin glue, and one case siyanoacrilate. The success of surgical treatment was 100%, and no postoperative fistulformation was observed. Two cases had meningitis on admission. During hospital stay, any case in this series developed meningitis. All patients were treated with prophylactic two combinations antibiotic therapy. For the precise evaluation of PBF, the efficacy of the conservative treatment and prophylactic antibiotic therapy, surgical indications of resistant cases, and appropriate surgical treatment was discussed with literature review.
Açıklama
Anahtar Kelimeler
Bos Fistülü, Kafa Travması, Otore, Rinore, Csf Fistula, Head Trauma, Otorrhea, Rhinorrhea
Kaynak
Ulusal Travma Dergisi
Ulusal Travma ve Acil Cerrahi Dergisi
Turkish Journal of Trauma and Emergency Surgery
Ulusal Travma ve Acil Cerrahi Dergisi
Turkish Journal of Trauma and Emergency Surgery
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
2
