錐体骨の骨欠損を原因とした難治性頭蓋内感染症に対する経頭蓋的修復術の有用性
側頭骨錐体部を介した髄液漏は，稀ではあるものの難治性の頭蓋内感染症を生じることが知られている．その原因には頭部外傷，錐体骨周辺の手術，腫瘍，放射線治療，中耳炎，先天性，特発性などが報告されているが，その原因の如何を問わず，繰り返す髄膜炎や致死的な重症頭蓋内感染症を生じうる．治療には髄液の漏出部位の正確な特定と速やかな閉鎖が推奨されるが，画像診断では同定困難なことが多い．そのため漏出する可能性がある部位を推測して同定することが重要である．本報告では経頭蓋的なアプローチによる欠損部の修復術により良好な経過をたどった治療経験をふまえ，効果的な修復術を達成するための工夫について述べる．...
Saved in:
| Published in | 日大医学雑誌 Vol. 81; no. 4; pp. 213 - 218 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本大学医学会
01.08.2022
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0029-0424 1884-0779 |
| DOI | 10.4264/numa.81.4_213 |
Cover
| Abstract | 側頭骨錐体部を介した髄液漏は，稀ではあるものの難治性の頭蓋内感染症を生じることが知られている．その原因には頭部外傷，錐体骨周辺の手術，腫瘍，放射線治療，中耳炎，先天性，特発性などが報告されているが，その原因の如何を問わず，繰り返す髄膜炎や致死的な重症頭蓋内感染症を生じうる．治療には髄液の漏出部位の正確な特定と速やかな閉鎖が推奨されるが，画像診断では同定困難なことが多い．そのため漏出する可能性がある部位を推測して同定することが重要である．本報告では経頭蓋的なアプローチによる欠損部の修復術により良好な経過をたどった治療経験をふまえ，効果的な修復術を達成するための工夫について述べる． |
|---|---|
| AbstractList | 側頭骨錐体部を介した髄液漏は，稀ではあるものの難治性の頭蓋内感染症を生じることが知られている．その原因には頭部外傷，錐体骨周辺の手術，腫瘍，放射線治療，中耳炎，先天性，特発性などが報告されているが，その原因の如何を問わず，繰り返す髄膜炎や致死的な重症頭蓋内感染症を生じうる．治療には髄液の漏出部位の正確な特定と速やかな閉鎖が推奨されるが，画像診断では同定困難なことが多い．そのため漏出する可能性がある部位を推測して同定することが重要である．本報告では経頭蓋的なアプローチによる欠損部の修復術により良好な経過をたどった治療経験をふまえ，効果的な修復術を達成するための工夫について述べる． |
| Author | 大島, 猛史 鴫原, 俊太郎 大谷, 直樹 倉田, 原哉 四條, 克倫 吉野, 篤緒 大島, 秀規 |
| Author_xml | – sequence: 1 fullname: 大島, 猛史 organization: 日本大学医学部耳鼻咽喉・頭頸部外科学分野 – sequence: 1 fullname: 吉野, 篤緒 organization: 日本大学医学部脳神経外科学系神経外科学分野 – sequence: 1 fullname: 鴫原, 俊太郎 organization: 日本大学医学部耳鼻咽喉・頭頸部外科学分野 – sequence: 1 fullname: 大谷, 直樹 organization: 日本大学医学部脳神経外科学系神経外科学分野 – sequence: 1 fullname: 大島, 秀規 organization: 日本大学医学部脳神経外科学系神経外科学分野 – sequence: 1 fullname: 四條, 克倫 organization: 日本大学医学部脳神経外科学系神経外科学分野 – sequence: 1 fullname: 倉田, 原哉 organization: 日本大学医学部脳神経外科学系神経外科学分野 |
| BookMark | eNo9UMtKw0AAXKSCtfboZ6RuNpvs5iJI8QUFL3oOmzTRlj4kqQdvplSLtEoxQtEKqXiwvioInsT6MWmS5i9MqXiZgXkdZhEkKtWKDsAyDzMYSXilclRmGcpnsIJ4YQ4keUoxBwmREyAJIZI5iBFeAGnLKqhQpFgWCMZJUI3anfG3Ez0PPHsYY_DaDzoXXv3Kv3T9Xt-zY73r2W7Uewg-voKTx6j_NnFa_tlp0HAD1wm7Tc9-8d9Hnn3j1VvhZ3sWCG8b45-hP3qa3DvxcnB3Hl4P4voSmDdYydLTf5wCexvru9ktLrezuZ1dy3FFhGTIyUhTiWiITNQpURFBCGpYkESDUCxRNU8gQbyINISpoTKi5XWJYh4aeUoMpomqkAKrs92iVWP7unJoFsrMPFaYWStoJV2Z3qVQXsFTiB_7N7QDZipFJvwC_WCOqQ |
| ContentType | Journal Article |
| Copyright | 2022 日本大学医学会 |
| Copyright_xml | – notice: 2022 日本大学医学会 |
| DOI | 10.4264/numa.81.4_213 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1884-0779 |
| EndPage | 218 |
| ExternalDocumentID | article_numa_81_4_81_213_article_char_ja |
| GroupedDBID | 5GY ALMA_UNASSIGNED_HOLDINGS F5P JSF RJT |
| ID | FETCH-LOGICAL-j2290-92cb75f5a5e87b27220c4365f78468bd7072152c248fba7cde68410fd87fac5b3 |
| ISSN | 0029-0424 |
| IngestDate | Wed Sep 03 06:30:33 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2290-92cb75f5a5e87b27220c4365f78468bd7072152c248fba7cde68410fd87fac5b3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/numa/81/4/81_213/_article/-char/ja |
| PageCount | 6 |
| ParticipantIDs | jstage_primary_article_numa_81_4_81_213_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2022/08/01 |
| PublicationDateYYYYMMDD | 2022-08-01 |
| PublicationDate_xml | – month: 08 year: 2022 text: 2022/08/01 day: 01 |
| PublicationDecade | 2020 |
| PublicationTitle | 日大医学雑誌 |
| PublicationTitleAlternate | 日大医誌 |
| PublicationYear | 2022 |
| Publisher | 日本大学医学会 |
| Publisher_xml | – name: 日本大学医学会 |
| References | 17) Gupta A, Sikka K, Irugu DVK, et al. Temporal bone meningoencephaloceles and cerebrospinal fluid leaks: experience in a tertiary care hospital. J Laryngol Otol 2019; 133: 192–200. 21) Savva A, Taylor MJ, Beatty CW. Management of cerebrospinal fluid leaks involving the temporal bone: report on 92 patients. Laryngoscope 2003; 113: 50–56. 18) Tóth M, Helling K, Baksa G, et al. Localization of congenital tegmen tympani defects. Otol Neurotol 2007; 28: 1120–1123. 14) Akimoto T, Morita A, Shiobara K et al. Surgically Cured, Relapsed Pneumococcal Meningitis Due to Bone Defects, Non- invasively Identified by Three-dimensional Multi-detector 倉田, 原哉・他6 名 Computed Tomography. Intern Med 2016; 55: 3665–3669. 11) Nahas Z, Tatlipinar A, Limb CJ, et al. Spontaneous meningoencephalocele of the temporal bone: clinical spectrum and presentation. Arch Otolaryngol Head Neck Surg 2008; 134: 509–518. 12) Byrne RW, Smith AP, Roh D, et al. Occult middle fossa encephaloceles in patients with temporal lobe epilepsy. World Neurosurg 2010; 73: 541–546. 10) Yew M, Dubbs B, Tong O, et al. Arachnoid granulations of the temporal bone: a histologic study of dural and osseous pene tration. Otol Neurotol 2011; 32: 602–609. 13) Arìstegui M, Falcioni M, Saleh E, et al. Meningoencephalic herniation into the middle ear: a report of 27 cases. Laryngo scope 1995; 105: 512–518. 22) Cooper T, Choy MH, Gardner PA, et al. Comparison of spontaneous temporal bone cerebrospinal fluid leaks from the mid dle and posterior fossa. Otol Neurotol 2020; 41: e232–e237. 5) Kutz JW Jr, Johnson AK, Wick CC. Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone. Laryngoscope 2018; 128: 2170–2177. 7) Glasscock ME 3rd, Dickins JR, Jackson CG, et al. Surgical management of brain tissue herniation into the middle ear and mastoid. Laryngoscope 1979; 89: 1743–1754. 16) Wick CC, Killeen DE, Clark M, et al. Posterior fossa spontaneous cerebrospinal fluid leaks. Otol Neurotol 2017; 38: 66– 72. 19) Pelosi S, Bederson JB, Smouha EE. Cerebrospinal fluid leaks of temporal bone origin: selection of surgical approach. Skull Base 2010; 20: 253–259. 9) Kutz JW Jr, Husain IA, Isaacson B, et al. Management of spontaneous cerebrospinal fluid otorrhea. Laryngoscope 2008; 118: 2195–2199. 8) Iurato S, Ettorre GC, Selvini C. Brain herniation into the middle ear: two idiopathic cases treated by a combined intracranial- mastoid approach. Laryngoscope 1989; 99: 950–954. 1) Roberts SA, Kamdar DJ, Mehta H, et al. Post-radiotherapy radionecrosis of the temporal bone resulting in delayed CSF otorrhoea: a case report. Br J Neurosurg 2013; 27: 125–127. 15) Nadaraja GS, Monfared A, Jackler RK. Spontaneous cerebrospinal fluid leak through the posterior aspect of the petrous bone. J Neurol Surg B Skull Base 2012; 73: 71–75. 2) Sanna M, Fois P, Russo A, et al. Management of meningoencephalic herniation of the temporal bone: personal experience and literature review. Laryngoscope 2009; 119: 1579–1585. 3) Wootten CT, Kaylie DM, Warren FM, et al. Management of brain herniation and cerebrospinal fluid leak in revision chron ic ear surgery. Laryngoscope 2005; 115: 1256–1261. 20) Jackson CG, Pappas DG Jr, Manolidis S, et al. Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management. Am J Otol 1997; 18: 198–205, discussion 205–206. 4) Kapur TR, Bangash W. Tegmental and petromastoid defects in the temporal bone. J Laryngol Otol 1986; 100: 1129–1132. 6) Aquilina K, Clarke DF, Wheless JW, et al. Microencephaloceles: another dual pathology of intractable temporal lobe epilepsy in childhood. J Neurosurg Pediatr 2010; 5: 360–364. |
| References_xml | – reference: 15) Nadaraja GS, Monfared A, Jackler RK. Spontaneous cerebrospinal fluid leak through the posterior aspect of the petrous bone. J Neurol Surg B Skull Base 2012; 73: 71–75. – reference: 20) Jackson CG, Pappas DG Jr, Manolidis S, et al. Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management. Am J Otol 1997; 18: 198–205, discussion 205–206. – reference: 13) Arìstegui M, Falcioni M, Saleh E, et al. Meningoencephalic herniation into the middle ear: a report of 27 cases. Laryngo scope 1995; 105: 512–518. – reference: 3) Wootten CT, Kaylie DM, Warren FM, et al. Management of brain herniation and cerebrospinal fluid leak in revision chron ic ear surgery. Laryngoscope 2005; 115: 1256–1261. – reference: 2) Sanna M, Fois P, Russo A, et al. Management of meningoencephalic herniation of the temporal bone: personal experience and literature review. Laryngoscope 2009; 119: 1579–1585. – reference: 4) Kapur TR, Bangash W. Tegmental and petromastoid defects in the temporal bone. J Laryngol Otol 1986; 100: 1129–1132. – reference: 11) Nahas Z, Tatlipinar A, Limb CJ, et al. Spontaneous meningoencephalocele of the temporal bone: clinical spectrum and presentation. Arch Otolaryngol Head Neck Surg 2008; 134: 509–518. – reference: 19) Pelosi S, Bederson JB, Smouha EE. Cerebrospinal fluid leaks of temporal bone origin: selection of surgical approach. Skull Base 2010; 20: 253–259. – reference: 1) Roberts SA, Kamdar DJ, Mehta H, et al. Post-radiotherapy radionecrosis of the temporal bone resulting in delayed CSF otorrhoea: a case report. Br J Neurosurg 2013; 27: 125–127. – reference: 5) Kutz JW Jr, Johnson AK, Wick CC. Surgical management of spontaneous cerebrospinal fistulas and encephaloceles of the temporal bone. Laryngoscope 2018; 128: 2170–2177. – reference: 22) Cooper T, Choy MH, Gardner PA, et al. Comparison of spontaneous temporal bone cerebrospinal fluid leaks from the mid dle and posterior fossa. Otol Neurotol 2020; 41: e232–e237. – reference: 7) Glasscock ME 3rd, Dickins JR, Jackson CG, et al. Surgical management of brain tissue herniation into the middle ear and mastoid. Laryngoscope 1979; 89: 1743–1754. – reference: 8) Iurato S, Ettorre GC, Selvini C. Brain herniation into the middle ear: two idiopathic cases treated by a combined intracranial- mastoid approach. Laryngoscope 1989; 99: 950–954. – reference: 9) Kutz JW Jr, Husain IA, Isaacson B, et al. Management of spontaneous cerebrospinal fluid otorrhea. Laryngoscope 2008; 118: 2195–2199. – reference: 16) Wick CC, Killeen DE, Clark M, et al. Posterior fossa spontaneous cerebrospinal fluid leaks. Otol Neurotol 2017; 38: 66– 72. – reference: 21) Savva A, Taylor MJ, Beatty CW. Management of cerebrospinal fluid leaks involving the temporal bone: report on 92 patients. Laryngoscope 2003; 113: 50–56. – reference: 18) Tóth M, Helling K, Baksa G, et al. Localization of congenital tegmen tympani defects. Otol Neurotol 2007; 28: 1120–1123. – reference: 12) Byrne RW, Smith AP, Roh D, et al. Occult middle fossa encephaloceles in patients with temporal lobe epilepsy. World Neurosurg 2010; 73: 541–546. – reference: 14) Akimoto T, Morita A, Shiobara K et al. Surgically Cured, Relapsed Pneumococcal Meningitis Due to Bone Defects, Non- invasively Identified by Three-dimensional Multi-detector 倉田, 原哉・他6 名 Computed Tomography. Intern Med 2016; 55: 3665–3669. – reference: 6) Aquilina K, Clarke DF, Wheless JW, et al. Microencephaloceles: another dual pathology of intractable temporal lobe epilepsy in childhood. J Neurosurg Pediatr 2010; 5: 360–364. – reference: 17) Gupta A, Sikka K, Irugu DVK, et al. Temporal bone meningoencephaloceles and cerebrospinal fluid leaks: experience in a tertiary care hospital. J Laryngol Otol 2019; 133: 192–200. – reference: 10) Yew M, Dubbs B, Tong O, et al. Arachnoid granulations of the temporal bone: a histologic study of dural and osseous pene tration. Otol Neurotol 2011; 32: 602–609. |
| SSID | ssib058493744 ssib004298531 ssib001535899 ssib007484389 ssj0000389138 ssib004001855 |
| Score | 2.3166294 |
| Snippet | 側頭骨錐体部を介した髄液漏は，稀ではあるものの難治性の頭蓋内感染症を生じることが知られている．その原因には頭部外傷，錐体骨周辺の手術，腫瘍，放射線治療，中耳... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 213 |
| SubjectTerms | 経頭蓋手術 脳脊髄液漏 錐体骨 頭蓋内感染症 |
| Title | 錐体骨の骨欠損を原因とした難治性頭蓋内感染症に対する経頭蓋的修復術の有用性 |
| URI | https://www.jstage.jst.go.jp/article/numa/81/4/81_213/_article/-char/ja |
| Volume | 81 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日大医学雑誌, 2022/08/01, Vol.81(4), pp.213-218 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1884-0779 dateEnd: 99991231 omitProxy: true ssIdentifier: ssib007484389 issn: 0029-0424 databaseCode: KQ8 dateStart: 20080101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3LaxNBGF9KBfEiPvFND84xcTM7szNznE03FKWC0EJvIfvIIWAVaS-eTKmKtEoxQtEKqXiwvioInsT6x6RJmv_C75vdTTfaQ-1lGGa_-X2v2Z1vdl6WdT10VADNArefSY7TjHYhgLi8ELiCurQURpHEvcPTt92pWXZzjs-NjZdzq5YWF4Ji-PDAfSVH8SqUgV9xl-x_eHYICgWQB_9CCh6G9FA-Jr4iskyUTXxGvEmiHCzRmmhJfAeCRKL9XIlLdJloGzNQRU4aGkoUJT4n0ieqghnlGZqkeoajRJapICDSOIjjUeJ5mJE20cLwggwgSxRGegYZnnJDw0x1F1MUVSCszJC1IdYV4vkZL5VKiDiCeByVPYAF4GgERyNUjMocQbRCGl0yvIbWAO5lIpWpxVKzGOHzYbohE0RzIxIzqhnuXiLkJNFuagdVMlxAgOH_5pFKnkM8FxsyckRnJTYBNWmeHh2ijD8FuiKlB2sAEOoO0uboFfFYarDEb4beqC91xl4bOFDcP0AwSTwbUVNGIBUgYguBByr_K4jS4ULE5OXN2cbYEtpUXt_UNv9aC6QD7XW-m6Q4Y5Zsbi_GSc8oJSvYIrn5J-s6k9t20k8EG-kHnVxIRZMu9u_eGoNxPP138W6tKEtFVh3WGjkAPX298IqcWlWWqgwTIK1mD3B_YrUBg6RjVLguXmNy605-Ktjh-althvdQ8vw_BAUh634nh4frOvtXMECADhF8GgOb8M7M7Mts6RiaKTm7F9W5MaIMRLUNGONl60NNyDpzyjqZjjUndKLAaWusUTtjHZ9OV9Octe4NVtd2f7UGn7Y6zW1Ie182e2vPO0svuy_a3Y3NThPK1zvN9mDjfe_7z96jD4PNr3utle6Tx73ldq_d6q8_7TQ_d7_tdJqvO0sr_R-rCUH_zfLu7-3uzse9dy1A7r191n-1BdXPWbMVf6Y8VUgvYCk08BqIgqJhIHid13gsRUAFpXbIHJfXBYxaZBAJPFyR05AyWQ9qIoxiV7KSXY-kqNdCHjjnrfH5e_PxBWsiihQe9SnsOBasHjhSRooJJ4bxYo3DuOuiJRJTVe8np-xUD-v2S0euedk6sf8WXbHGFx4sxldhiLEQXDNN6A9IbfVk |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E9%8C%90%E4%BD%93%E9%AA%A8%E3%81%AE%E9%AA%A8%E6%AC%A0%E6%90%8D%E3%82%92%E5%8E%9F%E5%9B%A0%E3%81%A8%E3%81%97%E3%81%9F%E9%9B%A3%E6%B2%BB%E6%80%A7%E9%A0%AD%E8%93%8B%E5%86%85%E6%84%9F%E6%9F%93%E7%97%87%E3%81%AB%E5%AF%BE%E3%81%99%E3%82%8B%E7%B5%8C%E9%A0%AD%E8%93%8B%E7%9A%84%E4%BF%AE%E5%BE%A9%E8%A1%93%E3%81%AE%E6%9C%89%E7%94%A8%E6%80%A7&rft.jtitle=%E6%97%A5%E5%A4%A7%E5%8C%BB%E5%AD%A6%E9%9B%91%E8%AA%8C&rft.au=%E5%A4%A7%E5%B3%B6%2C+%E7%8C%9B%E5%8F%B2&rft.au=%E5%90%89%E9%87%8E%2C+%E7%AF%A4%E7%B7%92&rft.au=%E9%B4%AB%E5%8E%9F%2C+%E4%BF%8A%E5%A4%AA%E9%83%8E&rft.au=%E5%A4%A7%E8%B0%B7%2C+%E7%9B%B4%E6%A8%B9&rft.date=2022-08-01&rft.pub=%E6%97%A5%E6%9C%AC%E5%A4%A7%E5%AD%A6%E5%8C%BB%E5%AD%A6%E4%BC%9A&rft.issn=0029-0424&rft.eissn=1884-0779&rft.volume=81&rft.issue=4&rft.spage=213&rft.epage=218&rft_id=info:doi/10.4264%2Fnuma.81.4_213&rft.externalDocID=article_numa_81_4_81_213_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0029-0424&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0029-0424&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0029-0424&client=summon |