Objective: To study the correlation between spontaneous cerebrospinal fluid rhinorrhea and increased intracranial pressure. Methods: Clinical data of patients with spontaneous cerebrospinal fluid rhinorrhea treated in the Department of Otorhinolaryngology of the Provincial Hospital of Shandong First Medical University from January 2019 to December 2023 and their epidemiology, clinical symptoms and signs, preoperative cerebrospinal fluid pressure, imaging data, leakage site, repair method and the presence or absebce of increased intracranial pressure were analysed. SPSS 23.0 software was used for statistical analysis. Results: Of the 57 patients with cerebrospinal fluid nasolacrimal leakage, 84.2%(48/57) were females and 15.8%(9/57) were males; 80.7%(46/57) were between 40 and 60 years old; and overweight and obese patients accounted for 75.4%(43/57). Of 57 patients, 35 patients received cranial MRI+magnetic resonance venography, and among them, 12(34.3%) patients were clinically with headache symptoms; the incidences of empty pterygoid and venous sinus stenosis were 40.0%(14/35) and 51.4%(18/35), respectively; and 33 patients underwent preoperative lumbar puncture examination, of whom 25(75.8%) patients had the increased cerebrospinal fluid pressure and 1 patient had idiopathic intracranial hypertension. All 57 patients underwent dural repair of the skull base, the postoperative follow-up period ranged from 3 to 60 months, and the success rate of surgery was 94.7%. The success rate was 100% in female patients and 33.3%(3/9) in male patients, including one with surgical failure receiving reoperation and two with postoperative recurrence in other areas of the skull base, with significant difference in the success rate of surgery between males and females (χ2=16.890, P<0.001). Conclusions: Most patients with spontaneous cerebrospinal fluid rhinorrhea have the increased cerebrospinal fluid pressures, but very few fulfil the diagnosis of idiopathic intracranial hypertension. The success rate of surgical repair alone is high, but some recurrences still exist, especially in male patients.
目的： 研究自发性脑脊液鼻漏与颅内压增高的临床相关性。 方法： 回顾性分析2019年1月至2023年12月在山东第一医科大学附属省立医院耳鼻喉科诊治的自发性脑脊液鼻漏患者的临床资料，记录其流行病学、临床症状和体征、术前脑脊液压力、影像学资料、漏口部位、修补方式等，总结存在颅内压增高表现的患者资料，对比男女性别手术成功率的差异。采用SPSS 23.0软件进行统计学分析。 结果： 57例脑脊液鼻漏患者中，女性占84.2%（48/57），男性占15.8%（9/57），年龄31~67岁，40~60岁之间者占80.7%（46/57）；超重、肥胖患者占75.4%（43/57）。35例患者完善了颅脑MRI+磁共振静脉造影，其中34.3%（12/35）患者临床伴有头痛症状，空蝶鞍与静脉窦狭窄比率分别为40.0%（14/35）和51.4%（18/35）。33例患者术前行腰穿检查，其中75.8%（25/33）患者脑脊液压力高于正常，1例患者符合特发性颅内压增高症的诊断。57例患者均进行颅底硬脑膜修复术，术后随访3~60个月，手术成功率94.7%。女性患者成功率达到100%；男性患者1例手术失败后再行手术，2例术后颅底其他区域复发；性别差异有统计学意义（χ2=16.890，P<0.001）。 结论： 多数自发性脑脊液鼻漏患者术前脑脊液压力高于正常，但符合特发性颅内压增高症诊断者极少。单纯手术修补的成功率高，远期仍存在一定的复发率。男性患者病因更复杂，远处复发率较高。.