Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea Using Bone Pate

Chatrath, Paul; Saleh, Hesham

doi:10.1097/01.mlg.0000217644.74806.8f

Cited by 10 publications

(13 citation statements)

References 14 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multilayer repair techniques using different tissue materials were described in literature [12][13][14][15]. In our study we mainly used fascia lata, fat, bone grafts, middle turbinate flap, and nasoseptal flap.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal multilayer repair of traumatic CSF rhinorrhea

Ibrahim

Okasha

Elwany

2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

The incidence of traumatic CSF has increased in recent years due to increased incidence of road traffic accidents (RTA) as well the increasing number of endoscopic sinus surgeries (ESS). The objective of this study is to present our experience in management of traumatic CSF leaks using the endoscopic multilayer repair technique. Forty-two patients (aged 10-75 years, 30 males and 12 females) presenting with confirmed post-traumatic CSF rhinorrhea were operated upon between January 2007 and December 2013. The endoscopic multilayer technique was used in all cases. Electromagnetic navigation was used in some cases. All cases presented with intermittent watery rhinorrhea. The duration of the rhinorrhea ranged from 3 days to 1 year before repair. One case presented after 10 years from the causative trauma. Ten cases had a history of meningitis. Nine cases had more than one defect. Iatrogenic defects were larger than defects following accidental trauma. Two cases, following RTA, developed pseudo-aneurysm of internal carotid artery. Ten cases had associated pneumocephalus. The mean duration of postoperative hospitalization was 6 days (range 4-8 days). The mean follow-up duration was 31.2 +/- 11.4 months (range 16-48 months). None of our patient developed serious intra- or postoperative complications. Only one case required another surgery to repair a missed second defect. Post-traumatic CSF leaks can be successfully managed via the endonasal endoscopic route using the multilayer repair technique. It is important to look for multiple defects in these cases. CT angiography is recommended for traumatic leaks involving the lateral wall of the sphenoid sinus to diagnose or exclude the development of pseudo-aneurysm of the internal carotid artery.

show abstract

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal multilayer repair of traumatic CSF rhinorrhea

Ibrahim

Okasha

Elwany

2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…From 2004 onwards, the defects <4 mm were continued to be repaired with the original 2 layered technique, however we adopted an anatomic three layered repair for the defects ≥ 4 mm (17,21) . The choice of graft material used varied according to the size and the site of the leak and included fascia lata or duragen®, septal cartilage, bone pate, fat and middle turbinate mucosa (21) . In ethmoid and olfactory defects a fascia lata underlay followed by septal cartilage and free turbinate mucosa was used.…”

Section: Reduction Of Herniated Mucosa or Diathermy Of An Encephalo-mentioning

confidence: 99%

Optimising outcomes in the management of spontaneous cerebrospinal fluid rhinorrhoea

Virk¹,

Elmiyeh²,

Stamatoglou³

et al. 2013

Rhin

View full text Add to dashboard Cite

show abstract

“…11 Mucosal grafting must be oriented carefully to ensure placement of the mucosal surface toward the nasal cavity or sinus to prevent mucocele formation or other intracranial complications. Nonmucosal soft graft materials consist of fascial grafts, fat, skin grafts, bone pate, 12 Duragen, and Alloderm, and firm grafts include cartilage, bone, Medpor (Stryker, Newnan, GA), and hydroxyapatite cement grafts. Once the primary graft monolayer or multiple layers are positioned, a variety of sealants and packing can be utilized to stabilize the graft during its initial healing and adherence to the defect site, including DuraSeal, GelFilm (Pfizer, New York, NY), Tisseel, Gelfoam, and Surgicel (Ethicon, Cornelia, GA).…”

Section: Discussionmentioning

confidence: 99%