Repair of encephalocele and cerebrospinal fluid leak with the use of bone morphogenetic protein: A case report

Slavnic, Dejan; Tong, Doris; Barrett, Ryan J.; Soo, Teck-Mun

doi:10.25259/sni-137-2019

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…7 However, there is significant discrepancy -a form of an "academic disconnect"-between the otolaryngology, neurosurgical, 1 and neurology literature regarding the management of spontaneous CSF leaks [11][12][13] . A significant number of otolaryngologists and neurosurgeons do not acknowledge the link to IIH, [14][15][16][17][18] hence missing the change of diagnosing and treating IIH early.…”

mentioning

confidence: 99%

International Consensus Statement: Spontaneous Cerebrospinal Fluid Rhinorrhea

Georgalas

Oostra

Ahmed

et al. 2020

Int Forum Allergy Rhinol

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Background The association between spontaneous cerebrospinal fluid CSF leak/rhinorrhea and idiopathic intracranial hypertension IIH has been increasingly recognized over the last years However considerable variability of opinion regarding the assessment investigations and management of patients with spontaneous CSF rhinorrhea remains Methods A consensus group was formed from experts from Europe Asia Australia South and North America Following literature review and open discussions with members of the panel a set of statements was produced A modified Delphi method was used to refine expert opinion with rounds of questionnaires and a consensus group meeting in Santo-Rhino meeting in September Results Fi y statements of total on spontaneous CSF leak and IIH reached consensus In of statements the median response was strongly agree and in the remaining statements the median response was agree Eleven statements were excluded because they did not reach consensus and one new statement was added during SantoRhino meeting The final statements refer to patient history and clinical examination "History taking should include presence of headache tinnitus and visual defects" investigations role of Thin Slice Computed Tomography and CISS/FLAIR sequences in Magnetic Resonance Imaging principles of management watchful waiting or measures to reduce ICP are supplementary but cannot subsitute surgical closure surgical technique intraoperative early postoperative and long term management Conclusion We present fi y consensus statements on the diagnosis investigation and management of spontaneous CSF rhinorrhea based on the currently available evidence and expert opinion Although by no means comprehensive and final we believe they can contribute to the standardization of clinical practice Early diagnosis prompt surgical closure of the defect assesment for and treatment of potentially co-existing idiopathic intracranial hypertension in a comprehensive multidisciplinary approach are essential in order to successfully manage spontaneous CSF rhinorrhea reduce associated morbidity and prevent recurrence

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mentioning

confidence: 99%

International Consensus Statement: Spontaneous Cerebrospinal Fluid Rhinorrhea

Georgalas

Oostra

Ahmed

et al. 2020

Int Forum Allergy Rhinol

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“…If this is left untreated, it may lead to permanent CSF fistulas, meningitis, and intractable seizures [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Encephalocele in a 16-Year-Old Male: A Rare Phenomenon

Oswal,

Hathi,

Shah

et al. 2023

Cureus

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The term "encephalocele" refers to the herniation of brain tissue caused by a cranial bone defect. It could be congenital, traumatic, neoplastic, or arise spontaneously. The possibility of traumatic fronto-ethmoidal encephalocele should be considered in patients who have experienced trauma. We report a case of a 16-year-old male with a recent history of a bike accident presented with sudden unilateral rhinorrhea. Non-contrast computed tomography (NCCT) brain was done, which showed findings of left fronto-ethmoidal encephalocele. The patient was managed with single-staged surgery without any complications.

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“…sCSF-Ls are most common in obese, middle-aged women and can cause significant patient morbidity (2). Herniation of dura and brain parenchyma through the bony defects can lead to meningocele or meningoencephalocele, which, if left untreated, may result in CSF fistulas, meningitis, and seizures (3). Those leaks that affect the lateral skull base (or tegmen) can also cause conductive hearing loss (CHL) and persistent ear effusions.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Postoperative CSF Leaks in Class III Obese Patients Undergoing Middle Cranial Fossa Approach for Spontaneous CSF Leak Repair

Cutri¹,

Shibata²,

Zhang³

et al. 2023

Otol Neurotol

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ObjectiveTo determine the safety and effectiveness of the middle cranial fossa (MCF) approach for spontaneous cerebrospinal fluid leak (sCSF-L) repair in class III obese patients. To also assess the need for prophylactic lumbar drain (LD) placement in this patient population.Study DesignRetrospective cohort study.SettingTertiary Academic Center.PatientsAll patients older than 18 years undergoing sCSF-L repair with an MCF approach.InterventionAn MCF craniotomy for sCSF-L repair.Main outcome measureRate of complications and postoperative leaks.ResultsThere were no perioperative complications in 78.9% (56/71) of cases. The surgical complication rate was 12.5% (2/16), 10% (2/20), and 22.2% (6/27) in class I, class II, and class III obese patients. There was no statistically significant difference in complications among these three groups. The most common postoperative complication was a persistent CSF leak in the acute postoperative period with an overall rate of 9.9% (7/71) with six of the seven patients requiring postoperative LD placement. The percentage of postoperative CSF leaks in nonobese, class I, class II, and class III patients were 25% (2/8), 12.5% (2/16), 0% (0/20), and 11.1% (3/27), respectively. There was no statistically significant difference in the rate of postoperative CSF leaks among the four groups (chi-square, p = 0.48). In all cases, the acute postoperative CSF leaks resolved in the long term and did not require further surgical repair.ConclusionsWe determine that MCF craniotomy repair for sCSF-Ls is safe in patients with class III obesity, and the incidence of postoperative CSF leaks did not vary among other obesity classes. We also find that prophylactic placement of LDs is not routinely needed in this population.

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Repair of encephalocele and cerebrospinal fluid leak with the use of bone morphogenetic protein: A case report

Cited by 4 publications

References 13 publications

International Consensus Statement: Spontaneous Cerebrospinal Fluid Rhinorrhea

International Consensus Statement: Spontaneous Cerebrospinal Fluid Rhinorrhea

Traumatic Encephalocele in a 16-Year-Old Male: A Rare Phenomenon

Incidence of Postoperative CSF Leaks in Class III Obese Patients Undergoing Middle Cranial Fossa Approach for Spontaneous CSF Leak Repair

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