Subcranial Transnasal Repair of Cerebrospinal Fluid Rhinorrhea with Free Autologous Grafts by the Combined Overlay and Underlay Techniques

Abstract

Subcranial transnasal repair with free autologous grafts by the combined overlay and underlay techniques using the endoscope or surgical microscope is a safe and successful method of treating CSF leaks, provided that the CSF leak is precisely located and the site can be reached with the endoscope or surgical microscope.

Surgical resection of type III juvenile angiofibroma without preoperative embolization

“…Intracranial intradural tumor without infiltration of the cavernous sinus, pituitary fossa, or optic chiasma IVb Intracranial intradural tumor with infiltration of the cavernous sinus, pituitary fossa, or optic chiasma cence of anterior skull base and disruption of dura mater, and arachnoid membrane, it was repaired endoscopically as described by El-Banhawy et al [9] At the end of surgery, the operated cavity was packed with layers of ribbon gauze soaked in gentamycin cream. It was stayed in place for 3 days.…”

Endoscopic Endonasal Approaches For Repair Of Cerebrospinal Fluid Leaks: Nine-Year Experience

“…In cases of unsuccessful conservative treatment, direct surgical repair of the leak is necessary, with traditional intracranial techniques or endoscopic endonasal techniques (9,10,20,24). The surgical management of a CSF fistula depends on the etiology of the leak, the location of the fistula and the temporal relationship of the leak to the causative factors (16,31). Surgical treatment, transcranial or endonasal, was compulsory in iatrogenic CSF leaks and in nontraumatic leakage (Fig.…”

“…1, 2 , 8, 9), while in 66.1% of the cases there was a bone defect of the anterior cranium base with a meningocele (28.8%) or a meningoencephalocele (37.3%) (Figs. [13][14][15][16][17]. In seven patients (11.9%) it was not possible to identify preoperatively the precise site of the leak.…”

“…C erebrospinal fluid (CSF) rhinorrhea involves a breakdown of all barriers that separate the subarachnoid space from the upper aerodigestive tract (14)(15)(16).…”

Cerebrospinal fluid rhinorrhoea: an overview of endoscopic multilayer repair

“…9 Single layer autograft technique along with fibrin glue was tried for small (<05 mm) defect by Holger G et al with success rate of 91.6%. 10 Schmerber S. et al used abdominal fat, fibrin glue and silastic sheet with success rate of ~95.5%. 11 Banhawy OA et al used fascia lata, septal cartilage and fat as a graft material with success rate of 100% (n=15).…”