Endoscopic transnasal intradural repair of anterior skull base cerebrospinal fluid fistulae

Briggs, Robert; Wormald, Peter John

doi:10.1016/j.jocn.2003.09.011

Cited by 63 publications

(55 citation statements)

References 13 publications

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“…3,[5][6][7]18) In this manner, even limited incisions to the abdomen or leg to harvest fascia lata or fat tissue can be avoided, as previous reconstructions have generally been performed using abdominal fat or fascia lata. 1,5,6,9,18) Nevertheless, no consensus has yet been established regarding the material or combination of materials and methods that can be considered the optimal remedy for repairing osteodural defects, with each option providing a similar number of pros and cons. The choice of adequate technique and materials to be used should therefore be addressed in each case based on the experience of the surgeon and the features of the osteodural defect.…”

Section: Discussionmentioning

confidence: 99%

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Komatsu

Cavallo

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 38-year-old woman presented with a case of post-traumatic ethmoidal cerebrospinal fluid (CSF) leak that was repaired using a purely endoscopic endonasal approach. Six weeks after a mild domestic maxillofacial trauma, she started complaining of clear, watery discharge from the left nostril and headache. Neuroimaging investigations disclosed a linear fracture of the left anterior ethmoidal roof without evidence of large bony breaches or any brain tissue damage. After conservative medical treatment with carbonic anhydrase inhibitors failed, she was referred to our hospital for surgical repair of the osteodural defect. An endoscopic endonasal transethmoidal approach was successfully performed, and an overlay technique was used to reconstruct the defect. The patient was discharged without clinical evidence of CSF rhinorrhea and no leaks were apparent at the 3-month follow-up clinical and radiological examinations. Post-traumatic CSF rhinorrhea occurs in cases of dural tears associated with small bone breaks, most frequently involving the anterior skull base. Recovery is often spontaneous following only bed rest, or with medical treatments such as inhibitors of carbonic anhydrase diuretics, steroids, or eventually stool softeners to help reduce CSF pressure. Surgical repair is required when first-line conservative treatment proves ineffective. The present case shows that the endoscopic endonasal technique for the management of CSF leaks provides a less invasive surgical route to achieve valid dural repair.

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Section: Discussionmentioning

confidence: 99%

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Komatsu

Cavallo

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…72,80 Various authors have successfully used different types of autologous and nonautologous grafts, such as a mucoperiosteal flap from the middle turbinate or septum or mucoperichondrial, osseous, cartilaginous, fat, muscular fascia, middle turbinate, or septum pedunculated graft, or any combination of these grafts. 1,3,11,13,15,22,[24][25][26]28,35,47,51,55,56,64,65,67,77,79,90,101,108 Another widely discussed issue in endoscopic transnasal repair is whether the grafts used for repair should be placed above (inlay) or beneath (onlay) the skull base defects. In a meta-analysis, Hegazy et al 53 found that both techniques yielded similar results.…”

Section: Surgical Managementmentioning

confidence: 99%

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Ziu¹,

Savage²,

Jimenez³

2012

FOC

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Cerebrospinal fluid rhinorrhea is a serious and potentially fatal condition because of an increased risk of meningitis and brain abscess. Approximately 80% of all cases occur in patients with head injuries and craniofacial fractures. Despite technical advances in the diagnosis and management of CSF rhinorrhea caused by craniofacial injury through the introduction of MRI and endoscopic extracranial surgical approaches, difficulties remain. The authors review here the pathophysiology, diagnosis, and management of CSF rhinorrhea relevant exclusively to traumatic anterior skull base injuries and attempt to identify areas in which further work is needed.

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“…El abordaje quirúrgico utilizado para la reparación del defecto ha sufrido un vuelco importante con el desarrollo de la cirugía endoscópica nasal 15 . La técnica endoscópica es hoy el tratamiento de elección gracias a su excelente visualización del defecto, baja morbilidad y tasas de más de 90% de éxito [16][17][18] . La técnica quirúrgica consiste en la colocación de un injerto que cubre la zona dehiscente que comunica la fosa craneal anterior con la fosa nasal.…”

Section: Discussionunclassified

Meningitis bacteriana aguda por Streptococcus agalactiae en una mujer no embarazada asociada a una fístula de LCR: comunicación de un caso

González

Labatut

Soto

et al. 2013

Rev. chil. infectol.

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Endoscopic transnasal intradural repair of anterior skull base cerebrospinal fluid fistulae

Cited by 63 publications

References 13 publications

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base -Case Report-

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

Meningitis bacteriana aguda por Streptococcus agalactiae en una mujer no embarazada asociada a una fístula de LCR: comunicación de un caso

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