Neuroendoscopic Treatment of Paediatric Cerebrospinal Fluid Rhinorrhoea

Abstract

Endoscopic management of CSF rhinorrhoea in children is usually associated with a higher incidence of mucosal abrasion and post-operative synechiae formation due to surgical manoeuvres in narrower nasal passages. We have used the Gaab universal neuroendoscope for the treatment of CSF rhinorrhoea in children. Three patients were treated in the last 2 years with this technique. All patients became completely asymptomatic after the initial procedure without any significant complications. We conclude that the treatment of CSF rhinorrhoea in children by means of a neuroendoscope with a working sheath may be effective and less traumatic to the nasal passage.

Cranionasal fistula in pediatric population: Is endonasal endoscopic approach effective?

“…We, in our study found males to be predominantly affected and is in accordance with the literature [6,7]. The etiology in our cases was trauma in 22 cases and spontaneous in three of the cases.…”

“…The etiology in our cases was trauma in 22 cases and spontaneous in three of the cases. Literature though is replete with the number of cases Neurosurgical intervention (a) Lateral wall 2 8 (b) Roof --managed endoscopically but mentions a relatively higher figure of 33% for the spontaneous rhinorrhoea [6,7]. The diagnosis is ascertained by the cytological and biochemical analysis of the fluid but the confirmatory test is the presence of beta transferrin in the fluid.…”

“…The prior work on endoscopic CSF repair in children consists of a few case reports only [6,7]. We here report our experience of endoscopic repair of the defect of anterior and middle skull base in 25 pediatric cases.…”

CSF rhinorrhea-feasibility of conservative management in children

“…They concluded that conservative treatment of CSF leaks may lead to bacterial meningitis, therefore surgical closure of leaks or defects at the skull base should be considered treatment of choice to prevent ascending meningitis [26]. We, in our study found males to be predominantly affected and is in accordance with the literature [27,28]. The age ranged from 3 years to 14 years.…”

Endonasal Endoscopic Approach in Management of Paediatric CSF Rhinorrhoea Cases

“…Vrabec and Hallberg [9] in 1964 described the endonasal approach for closure of defects in sphenoid sinus and cribriform plate, since then endonasal endoscopic approach has evolved a lot, with the recent literature quoting a success rate of up to 90 % [10,11] it has become the initial treatment of choice for CSF rhinorrhoea repair. But excepting for one case series [12] of paediatric cases with CSF rhinorrhoea with a success rate of 96 %, rest all literature consists of only individual case reports [13,14]. Due to the paucity of literature no specific criteria or consensus is available with regards to management of paediatric patients, specifically in the below 5 years age group.…”