Surgical treatment of refractory cerebrospinal fluid rhinorrhea with recurrent bacterial meningitis in 1 case and literature review / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the surgical treatment of refractory cerebrospinal fluid rhinorrhea with recurrent bacterial meningitis.Methods The clinical data of 1 case of a 10-year-old boy who had 9 episodes of bacterial meningitis and underwent 4 surgical repair procedures for congenital cerebrospinal fluid rhinorrhea at the Children's Hospital Affiliated to Soochow University were analyzed,and the related literatures were reviewed.Results During the intervals of 9 episodes of bacterial meningitis,the patient experienced 4 neurosurgical repairs of cerebrospinal fluid rhinorrhea,including 2 endoscopic repairs via the lateral nasal cavity,a craniotomy approach repair via forehead epidural,and an endoscopic repair in combination with a ventriculo-peritoneal shunt.The first 3 surgeries were all failed,but the final surgery was successful,with no recurrence of cerebrospinal fluid rhinorrhea or bacterial meningitis in 3.5 years of follow-up.Conclusions For recurrent meningitis and refractory cerebrospinal fluid rhinorrhea,the ventriculo-peritoneal shunt can be considered in addition to conventional nasal endoscopic cerebrospinal fluid repair to eliminate the increased cerebrospinal fluid attributable to long-term chronic compensation,and effectively reduce postoperative intracranial hypertension to make the operation success.