Endoscopic transnasal management of cerebrospinal fluid leaks of the sphenoid sinus

Muscatello, Luca; Lenzi, Riccardo; Dallan, Iacopo; Seccia, Veronica; Marchetti, Mirco; Sellari–Franceschini, Stefano

doi:10.1016/j.jcms.2009.10.013

Cited by 22 publications

(35 citation statements)

References 25 publications

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“…A proper training in endoscopic endonasal surgery is mandatory, and the surgical team should be experienced in the management of benign conditions (Muscatello et al, 2010) before treating more complex pathologies, such as malignant tumours of the skull base. In this report we present the University of Pisa experience in the management of selected ethmoidal malignancies.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal craniotomy in the management of selected ethmoidal malignancies: The University of Pisa experience

Muscatello¹,

Dallan²,

Seccia³

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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Section: Introductionmentioning

confidence: 99%

Endoscopic endonasal craniotomy in the management of selected ethmoidal malignancies: The University of Pisa experience

Muscatello¹,

Dallan²,

Seccia³

et al. 2011

Journal of Cranio-Maxillofacial Surgery

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“…Of all the CSF leaks, those from the sphenoid sinus represent a unique challenge due to the anatomical rapport and the extreme variability in the shape of the sinus [2]. In our case, a ventriculoperitoneal shunt was performed resulting in the cessation of the rhinorrhea and the disappearance of the papilledema.…”

Section: Discussionmentioning

confidence: 94%

“…Wigand first reported a successful procedure in 1981 [21]. The success rate of the endoscopic technique is reported as 90 % at the first attempt, increasing to 97 % at the second attempt [2, 7, 20]. The defects can be covered by materials including a tissue graft such as abdominal fat, nasal mucosa, galeal frontalis flap, musculature, lyophilized dura mater or fascia lata, which is very suitable because it is autologous material and does not shrink in the way that other tissues, such as muscle, do [19, 22].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous cerebrospinal fluid leak of the sphenoid sinus mimicking allergic rhinitis, and managed successfully by a ventriculoperitoneal shunt: a case report

et al. 2016

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BackgroundSpontaneous cerebrospinal fluid leaks are rare but may lead to confusion with other diseases in patients without history of trauma. We report a rare case unusual for two reasons. First, our patient was put under antiallergic medication for months before the diagnosis of spontaneous cerebrospinal fluid leak of the sphenoid sinus. Second, our patient was managed successfully by a ventriculoperitoneal shunt.Case presentationOur patient was a nonobese 49-year-old Arab man without history of trauma or surgery who presented with rhinorrhea. He was given allergic rhinitis medication for 4 months without improvement. After the onset of headache leading to the suspicion of paranasal sinusitis, a computed tomography scan discovered an osteodural defect in the sphenoid sinus roof and a magnetic resonance imaging scan showed an aspect of empty sella with an arachnoidocele. An eye fundus examination found papilledema suggesting the diagnosis of idiopathic intracranial hypertension. We performed a ventriculoperitoneal shunt without repair of the osteodural defect. Because of the favorable evolution, we decided to postpone surgery.ConclusionsSpontaneous cerebrospinal fluid leak should be considered even in nonobese male patients without history of trauma. Our observation adds to other case reports suggesting the decrease of cerebrospinal fluid pressure alone as an option for the treatment of spontaneous cerebrospinal fluid leaks. Additional studies are necessary to clarify the indications.

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“…This doesn’t preclude their use in individual cases – especially because the whole spectrum – from no lumbar drainages [67] to 100% [57], [68] and the whole spectrum in between these extremes [69], [70], [71] can be found in publications – without obvious effects on the rate of success.…”

Section: Techniques and Executionmentioning

confidence: 99%

The transnasal approach to the skull base. From sinus surgery to skull base surgery

Wagenmann,

Schipper

2011

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 10:Doc08; ISSN 1865-1011

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Endoscopic transnasal management of cerebrospinal fluid leaks of the sphenoid sinus

Cited by 22 publications

References 25 publications

Endoscopic endonasal craniotomy in the management of selected ethmoidal malignancies: The University of Pisa experience

Endoscopic endonasal craniotomy in the management of selected ethmoidal malignancies: The University of Pisa experience

Spontaneous cerebrospinal fluid leak of the sphenoid sinus mimicking allergic rhinitis, and managed successfully by a ventriculoperitoneal shunt: a case report

The transnasal approach to the skull base. From sinus surgery to skull base surgery

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