Endoscopic repair of cerebrospinal fluid rhinorrhea

Kljajić, Vladimir; Vuleković, Petar; Vlaški, Ljiljana; Savovic, Slobodan; Dragičević, Danijela; Papić, Vladimir

doi:10.1016/j.bjorl.2016.04.024

Cited by 19 publications

(12 citation statements)

References 22 publications

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“…Kljajić et al [11] reported that male patients outnumbered female ones in the group of traumatic CSF leaks, while most of the patients with spontaneous CSF leaks were female ones. Our study confirms that spontaneous Fig.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Endoscopic Cerebrospinal Fluid Rhinorrhoea Repair: An Institutional Study

Majhi

Sharma

2018

Indian J Otolaryngol Head Neck Surg

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Cerebrospinal fluid Rhinorrhoea is caused by an abnormal open communication between the subarachnoid space and the nasal cavity. The most common anatomic sites of such abnormal communication are found in the anterior skull base, namely, ethmoid roof, olfactory groove, roof of the sphenoid sinus and the posterior wall of the frontal sinus. It can be classified into traumatic or spontaneous. Spontaneous leaks are associated with highest recurrence rates following surgical repair. The repair of CSF Rhinorrhoea has rapidly evolved over the past 30 years. Prior to the advent of the endoscopic approach, craniotomy was used for repairs which carried a variable success rate and morbidity. The purpose of our study was to ascertain the outcome after Transnasal Endoscopic Repair of spontaneous CSF leaks. This was a prospective study conducted at the Department of ENT at Safdarjung Hospital, New Delhi between January 2015 and June 2016. The study comprised of eleven patients who presented with the complaint of watery nasal discharge and were diagnosed to have spontaneous CSF Rhinorrhoea. Proper clinical examination, nasal endoscopy and biochemical and cytological analysis of nasal secretions of the patient was done. High Resolution Computed Tomography and MRI scans of the nose and paranasal sinuses were done to identify precise location of CSF leak and the size of fistula. CT cisternography was done wherever required. Fistula was repaired via Transnasal endoscopic approach in a multi layered underlay fashion. Out of all eleven patients with spontaneous CSF leaks, most common site of leak was from left cribriform area. Four patients (36.36%) were found to have meningoencephalocele. No associated intracranial lesion was found and all patients did not have any benign intracranial hypertension. Our success rate of endoscopic repair on first attempt was 100% with recurrence in 1 patient after 4 months of repair. Endoscopic repair of CSF rhinorrhoea is safe and effective, with a very low complication rate. It has almost completely replaced the older open techniques. Accurate localization of leak site followed by multilayered closure of dural defect appear to be essential for successful endoscopic repair.

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Section: Discussionmentioning

confidence: 99%

Outcome of Endoscopic Cerebrospinal Fluid Rhinorrhoea Repair: An Institutional Study

Majhi

Sharma

2018

Indian J Otolaryngol Head Neck Surg

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“…The extended skull base exposure with ESBS increases the incidence of CSF leak to 7% [29]. Common sites for anterior skull base defects are in the ethmoid and sphenoid sinuses [30,31]. Recognising skull base damage and subsequent CSF leak during initial FESS allows concurrent repair; missed skull base damage may require additional surgical reparative procedures, adding to the patient's morbidity and inpatient stay [32].…”

Section: Cerebrospinal Fluid Rhinorrhoeamentioning

confidence: 99%

“…MRI and MR cisternography are useful in situations of multiple bony defects, or where the site of defect cannot be identified on CT [33]; CT cisternography may be reserved for cases where these have failed to identify a source. Intrathecal perioperative fluorescein can be utilised in cases where all available imaging modalities have been exhausted [30].…”

Section: Cerebrospinal Fluid Rhinorrhoeamentioning

confidence: 99%

Managing Complications and Revisions in Sinus Surgery

Khanna

Sama²

2019

Curr Otorhinolaryngol Rep

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Purpose of Review To discuss strategies to avoid, identify and deal with both minor and major complications, as well as indications for revision sinus surgery. Recent Findings Complication rates from endoscopic sinus surgery are low and have improved with increased surgical experience and new technology. Early extensive surgery in patients with complex sinonasal disease can improve long-term outcomes. Summary A majority of patients undergoing endoscopic sinus surgery have a positive outcome. The surgeon must be competent in recognising and dealing with potential complications, as well as approaching complex revision cases.

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“…The extracranial approach, such as the transnasal endoscopic surgical repair, has proved to be surgical interventions with minimal complications and a high success rate. 1,7 Surgical repair by Craniotomy was performed in the past, with a 60-80% success rate. Whereas open surgical repair requires a wide coronal incision with a high risk of permanent anosmia as a major complication.…”

Section: Introductionmentioning

confidence: 99%

Transnasal Endoscopic Surgical Repair of Cerebrospinal Fluid(CSF) Rhinorrhea by Inferior Turbinate Grafts

Saleem¹,

Rehman²,

Khan³

et al. 2021

JRMC

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Objective: The study aims to evaluate the outcomes of transnasal endoscopic surgical repair of CSF rhinorrhoea.Materials and Methods: After approval from the institutional ethical committee (DME-396-18) and patient consent, a descriptive study of 27 patients with cerebrospinal fluid rhinorrhea was conducted at Aziz Fatimah Trust Hospital Faisalabad from August 21, 2018, to February 7, 2021. Transnasal endoscopic surgical repair of Cerebrospinal fluid leak was performed by using multilayer technique using a graft from the inferior turbinate. The data collected were analyzed using SPSS 20.Results: The most common site of the CSF leak was the left side of the cribriform plate (n=19,70%). The most common etiology was spontaneous (n=16,59%). At the same time, traumatic CSF leak (n=16,59%). was the second common etiological factor. The surgical procedure used in the study reported a 93%(n=25) success rate. The success rate was 97.5% on revision surgeries.Conclusion: Transnasal endoscopic surgical repair of CSF leak is one of the most effective and safe surgical interventions. Multilayer technique is not only safe but also has lesser complications. Moreover, this minimizes the risk for the development of secondary wounds as compared to other surgical processes.

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Endoscopic repair of cerebrospinal fluid rhinorrhea

Abstract: Endoscopic diagnosis and repair of cerebrospinal fluid fistulas using fluorescein intrathecally has high success rate and low complication rate.

Cited by 19 publications

References 22 publications

Outcome of Endoscopic Cerebrospinal Fluid Rhinorrhoea Repair: An Institutional Study

Outcome of Endoscopic Cerebrospinal Fluid Rhinorrhoea Repair: An Institutional Study

Managing Complications and Revisions in Sinus Surgery

Transnasal Endoscopic Surgical Repair of Cerebrospinal Fluid(CSF) Rhinorrhea by Inferior Turbinate Grafts

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