Extended applications of endoscopic sinus surgery and its reference to cranial base and pituitary fossa

Gendeh, Balwant Singh

doi:10.1007/s12070-010-0077-6

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…Based on the various diagnostic modalities used, of the 20 patients, 35% of the patients had CSF leaks from the sphenoid sinus (n=7), 60% from the cribriform plate and (n=12) 5% from the fovea ethmoidalis (n=1). This is consistent with a study by Lund VJ in 2006 concluding that the commonest sites for congenital dehiscence is the cribriform niche adjacent to the vertical attachment of the middle turbinate anteriorly and the superior and lateral walls of the sphenoid posteriorly 18,16,19] . CT scans of 2 patients with spontaneous CSF rhinorrhoea with leaks from the right cribriform plate and the lateral recess of the sphenoid are shown in Figure 4(a) and Figure 4(b) respectively.…”

Section: Methodssupporting

confidence: 92%

“…At this centre, the technique includes the bath plug technique where fat is harvested from the ear lobe or sub-umbilical region and is introduced, with vicryl into the intradural space usually used when the defects are smaller than 15mm. The middle turbinate is used either as a graft or free flap to stabilize and reinforce the repair [19]. Looking retrospectively at the three patients who had recurrent leaks, one patient had BIH and ESS whose leak recurred after seven years, one patient had symptoms of increased intracranial pressure and another had BMI of 32.9 with no symptoms of increased ICP, both recurrences occurred within 2 years of the first surgery.…”

Section: Methodsmentioning

confidence: 99%

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Spontaneous cerebrospinal fluid rhinorrhoea and its association with body mass index (BMI)

Wen

Gendeh²,

Husain

et al. 2019

Bangladesh J Med Sci

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Objective: The purpose of this study is to review the correlation of spontaneous cerebrospinal fluid rhinorrhoea (CSFR) and Body Mass Index (BMI) and describe the demographics, the surgical techniques and outcomes. Materials and methods: We performed a retrospective review of clinical data of twenty patients diagnosed with spontaneous CSFR and treated at the Malaysian National University Medical Centre from 1997 to 2015. Result and Discussion: A total of 20 patients were selected in this research (19 females,1male). The mean age was 45.5 years with nineteen females and one male patient. The mean BMI was 33.1kg/m 2 .Majority of patients with spontaneous leaks are females in their forties. The bath plug technique, onlay of middle turbinate grafts, nasoseptal flaps and mucoperiosteal grafts techniques were used and three patients reported recurrences. Conclusion: Spontaneous CSFR is more common in women in their 40s with BMI>25. The most common sites of leaks are the cribriform plate followed by the sphenoid sinus. Spontaneous CSFR cases are strongly related with increased BMI.

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Section: Methodssupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Spontaneous cerebrospinal fluid rhinorrhoea and its association with body mass index (BMI)

Wen

Gendeh²,

Husain

et al. 2019

Bangladesh J Med Sci

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“…8,10 Also, in our study use of only fat for repair of grade I CSF leak was sufficient without any postoperative leak rather than an overdoing repair as described in literature such as multilayer method or dural graft repair. 10,11 In grade II CSF leak, multilayer method was adequate with minimal (n=1) recurrence rate. Grade III CSF leak required a robust repair with cartilage buttress in recurrence cases.…”

Section: Discussionmentioning

confidence: 96%

Cerebrospinal Fluid Leak in Transnasal Transsphenoidal Surgery for Pituitary Adenoma and its Management

Singh

Roy

Chandankhede

et al. 2021

BJOHNS

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Introduction Over the past few decades endoscopic transnasal transsphenoidal (ETNTS) approach has been practised for excision of pituitary tumours which has minimised the rate of complications and morbidity. However, cerebrospinal fluid (CSF) leak remains a frequent complication requiring efficient management. Various skull-base repair techniques have been described in the literature all along, but there is no universal protocol for the same. Our study aims to determine an ideal strategy for skull-base repair following ETNTS surgery and suggest a protocol at the tertiary centre for the same. Materials and Methods In this prospective study, patients with pituitary adenoma undergoing ETNTS excision from January 2017 to May 2019 were included. Data were collected based on the intraoperative findings of grade of CSF leak following excision, surgical method for skull-base repair, biomaterials used, and recurrence of CSF leak postoperatively and its management. Results A total of 141 patients between 10 to 74 years of age (mean age 42.6) underwent ETNTS excision of pituitary adenoma. Intraoperative CSF leak was observed in 30.5% patients with 14.1% of grade I, 8.5% of grade II and 7.8% of grade III and repair was done with fat closure, multilayer closure and with naso-septal flap, respectively. Postoperative recurrence of CSF leak was found in 2.83% of total cases and 9.3% of patient with intraoperative leak, which were managed appropriately. Overall closure rate was 100% with no further recurrence of CSF leak. Conclusion Surgical repair of skull-base in CSF leak is challenging and requires management in careful and graded fashion for favourable outcome.

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“…Malignancy of the sac can present with symptoms of bloody discharge from the punctum which will need further investigations. A dacryocystocele can present with epiphora, swelling, or recurrent dacryocystitis ( Figure 10A and B) [4]. Wegener…”

Section: Surgical Indicationsmentioning

confidence: 99%

Endoscopic Dacryocystorhinostomy

Gendeh¹

2019

Endoscopy - Novel Techniques and Recent Advancements

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Epiphora, or abnormal tearing, occurs because of the blockage in the lacrimal drainage system, which impairs normal tearing channeling into the nose. It is essential that with proper history and examination including syringing and probing, a correct diagnosis is made. Syringing and probing are performed only in congenital and acquired nasolacrimal duct obstruction (NLDO). Dacryocystorhinostomy (DCR) is a procedure performed for the treatment of tearing (epiphora) due to blockage of the nasolacrimal drainage system. Endoscopic dacryocystorhinostomy (E-DCR) using telescopes has gained a lot of momentum among otolaryngologists, since the outcomes are comparable to the external approach. Advances in surgical technique and a better understanding of the anatomy have resulted in improvements in outcomes. The anatomy of the lacrimal system will be discussed in detail including the surgical indications and techniques of DCR. The advantages, results, and complications of surgery will be highlighted.

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Extended applications of endoscopic sinus surgery and its reference to cranial base and pituitary fossa

Cited by 5 publications

References 37 publications

Spontaneous cerebrospinal fluid rhinorrhoea and its association with body mass index (BMI)

Spontaneous cerebrospinal fluid rhinorrhoea and its association with body mass index (BMI)

Cerebrospinal Fluid Leak in Transnasal Transsphenoidal Surgery for Pituitary Adenoma and its Management

Endoscopic Dacryocystorhinostomy

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