Background Cerebrospinal fluid (CSF) rhinorrhea is a condition where the protective fluid that surrounds the brain finds its way into the nose and sinuses, often appearing as a very watery runny nose. The main surgical approaches for the surgical repair of CSF leaks are intracranial and extracranial. Over the last decade, endoscopic surgery has established itself as the most widely used technique for the repair of CSF fistula. The current study aimed to describe the use of nasal endoscopic technique in the management of cerebrospinal fluid rhinorrhea repair. Results Results of our study showed that in addition to CSF leak, 40% of the patients had headache and 17.5% had repeated meningitis. Half of the etiologies for the CSF leak were spontaneous, 35% were congenital, and 15% were traumatic. The more frequent site of leak was left cribriform plate (37.5%). In the majority of patients, 37/40 (92.5%), the type of graft was tensor fascia lata and fat, while in the remaining 3 patients, type of graft was tensor fascia lata and bone, bone and fat, and tensor fascia lata. The repair succeeded in 35 patients giving a success rate of 87.5%. Conclusion It can be concluded that wide range of age groups from 2–62 years presented as CSF rhinorrhea with female predominance, and there was high success rate of endoscopic CSF rhinorrhea repair with low morbidity.
Background: Regional anesthesia is frequently used in obstetric, orthopedic, and urological procedures, commonly intrathecal and epidural local anesthetics are combined with opioids to prolong analgesia; however, these do not prolong the motor block time and can attenuate the response to surgical stress, in addition to being associated with side effects such as respiratory depression, urinary retention, pruritus, hemodynamic instability, nausea, and emesis. Objective: to investigate the effect of adding 75 mg ofmagnesium sulfate on the duration of sensory block and duration of motor block Patients and Methods: In a prospective randomized study, ASA I or II, 128 (64 control and 64 experimental groups) pregnant women (at term) who were candidate for cesarean section with spinal anesthesia, were recruited in this study. They were collected from "Baghdad Teaching Hospital" at the period from (September 2020 to Fab 2021).Each experimental woman received 12.5 mg (2.5 ml) of hyperbaric bupivacaine (0.5%) and 0.5 ml (75 mg) magnesium sulfate (15%), while controls received same does of hyperbaric bupivacaine and 0.5 ml of distilled water. Results:The duration of analgesia (sensory blockade) and theduration of motor blockade manifested a statistically significant increase inexperimental as compared to their controls (control = 116.41 ± 12.47,experimental = 159.75 ± 10.56, control = 180.76 ± 11.83, experimental = 240 ±9.46 minutes respectively). Conclusion:Significantly increased the duration ofpostoperative analgesia and prolonged the sensory and motor blockade withoutsignificant apparent maternal or fetal side effects.
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