Image‐guided endoscopic repair of cerebrospinal fluid rhinorrhea by the bath plug grafting technique

Saleh, Hazem Mohammad Ali; Bahkaly, Sameer Al

doi:10.1002/lary.21355

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…A total of 26 cohort studies 9–34 and 6 case series 6,35–39 used HRCT in 622 patients. The cohort studies reported a sensitivity of 0.93 (0.65-1.00) (median [IQR]) and specificity of 0.50 (0.00-1.00), while the case series reported a sensitivity of 1.00 (0.79-1.00) and specificity of 1.00 (0.00-1.00).…”

Section: Resultsmentioning

confidence: 99%

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Diagnosis and Localization of Cerebrospinal Fluid Rhinorrhea: A Systematic Review

Xie

Zhou

Kachra

et al. 2021

Am J Rhinol�Allergy

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Background Cerebrospinal fluid (CSF) rhinorrhea results from abnormal communications between the subarachnoid and sinonasal spaces. Accurate preoperative diagnosis and localization are vital for positive clinical outcomes. However, the diagnosis and localization of CSF rhinorrhea remain suboptimal due to a lack of accurate understanding of test characteristics. Objective This systematic review aims to assess the diagnostic accuracy of various tests and imaging modalities for diagnosing and localizing CSF rhinorrhea. Methods A systematic review of the MEDLINE and EMBASE databases was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Our search identified 4039 articles—53 cohort studies and 24 case series describing 1622 patients were included. The studies were heterogeneous and had a wide range of sensitivities and specificities. Many specificities were incalculable due to a lack of true negative and false positive results, thus precluding a meta-analysis. Median sensitivities and specificities were calculated for cohort studies of the following investigations: high-resolution computed tomography (HRCT) 0.93/0.50 (sensitivity/specificity), magnetic resonance cisternography (MRC) 0.94/0.77, computed tomography cisternography (CTC) 0.95/1.00, radionuclide cisternography (RNC) 0.90/0.50, and contrast-enhanced magnetic resonance cisternography (CEMRC) 0.99/1.00, endoscopy 0.58/1.00, topical intranasal fluorescein (TIF) 1.00/incalculable, intrathecal fluorescein (ITF) 0.96/1.00. Case series were reviewed separately. Etiology and site-specific data were also analyzed. Conclusion MR cisternography is more accurate than high-resolution CT at diagnosing and localizing CSF rhinorrhea. CT cisternography, contrast-enhanced MR cisternography, and radionuclide cisternography have good diagnostic characteristics but are invasive. Intrathecal fluorescein shows promising data but has not been widely adopted for purely diagnostic use. Office endoscopy has limited data but does not sufficiently diagnose CSF rhinorrhea independently. These findings confirm with current guidelines and evidence.

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Section: Resultsmentioning

confidence: 99%

“…Office Endoscopy. Four cohort studies 12,14,22,23 and 2 case series 77,78 used endoscopy in 66 patients. The sensitivity of the cohort studies was 0.58 (0.13-1.00).…”

Section: Radionuclide Cisternography (Rnc)mentioning

confidence: 99%

Diagnosis and Localization of Cerebrospinal Fluid Rhinorrhea: A Systematic Review

Xie

Zhou

Kachra

et al. 2021

Am J Rhinol�Allergy

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“…Very few papers have been published locally, and little is known about the management trends of CSF rhinorrhea in Saudi Arabia [17][18][19]. In this retrospective cohort, we aim to present the nine-year experience of a major tertiary center elucidating the etiologies, management, and outcomes of CSF rhinorrhea.…”

Section: Introductionmentioning

confidence: 99%

The Etiology, Diagnosis, and Management of Cerebrospinal Fluid Rhinorrhea: A Tertiary Center Experience

Noori,

Hamdan,

Alaqsam

et al. 2023

Cureus

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Introduction The aim of the present study was to describe our institution’s nine years of experience in the endoscopic endonasal management of cerebrospinal fluid (CSF) rhinorrhea and to discuss the causes, sites, and outcomes. Methodology The medical records of patients diagnosed with CSF rhinorrhea in King Abdulaziz Medical City-Jeddah (KAMC-J) between 2014 and 2023 were retrospectively reviewed, and all relevant information including body mass index, medical and surgical history, and postoperative outcomes were obtained. Results A total of 20 cases were included in the present study, sixteen (80%) of which were females and four (20%) were males. The mean age of participants was 42.59±13.9 years. Nine cases (45%) were spontaneous CSF rhinorrhea and 11 (55%) were traumatic; within the traumatic group, six cases (54%) were iatrogenic either following previous neurosurgery or functional endoscopic sinus surgery, while the remaining five cases were related to motor vehicle accidents. The mean body mass index for the spontaneous CSF leak was 32 Kg/m 2 , and 33 Kg/m 2 for the traumatic leaks, no statistically significant difference was noted. The cribriform plate was the most common site of leakage (65%). A multilayer surgical technique using facia lata graft with nasoseptal flap was the most common choice for reconstruction with a first-attempt success rate approximating 90%. A recurrence was observed in two patients only. No major complications were reported. The average length of stay was nine days. Conclusion The endoscopic endonasal repair of CSF leak is a safe and reliable procedure and is associated with high success rates and low risk of complications. Therefore, it should be preferred as a first-line treatment for CSF rhinorrhea.

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“…Very few studies [7,8] on CSF rhinorrhea have been conducted in Saudi Arabia. At King Abdulaziz University Hospital (KAUH), there are no available data on the etiology, diagnosis and management of this condition.…”

Section: Introductionmentioning

confidence: 99%

Cerebrospinal Fluid Rhinorrhea: Causes, Sites, Management and Recurrence

2012

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, from January 2003 to May 2011 were retrospectively reviewed. Ten cases of cerebrospinal fluid rhinorrhea were treated during the study period. The most frequent causes were endoscopic sinus surgery (50%), spontaneous (30%) and others (20%). Defects were located at the cerebriform plate (n = 6), left fronto-ethmoidal area (n = 1), at roof of the left frontal sinus (n = 1), at the junction between the cerebriform plate and bulla ethmoidalis (n = 1), and at the roof of the sphenoid sinus (n = 1). Patients were followed up for 6 to 24 months. The initial closure was successful in 6 patients; 5 after endoscopic sinus surgery and 1 after conservative treatment. Overall closure rate was 90.0%; 87.5% after endoscopic sinus surgeries. In conclusion, the most frequent cause of cerebrospinal fluid rhinorrhea was endoscopic sinus surgery and the cerebriform plate was the most common defect location. The overall rate of closure after endoscopic sinus surgery and conservative treatment was high.

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Image‐guided endoscopic repair of cerebrospinal fluid rhinorrhea by the bath plug grafting technique

Cited by 5 publications

References 14 publications

Diagnosis and Localization of Cerebrospinal Fluid Rhinorrhea: A Systematic Review

Diagnosis and Localization of Cerebrospinal Fluid Rhinorrhea: A Systematic Review

The Etiology, Diagnosis, and Management of Cerebrospinal Fluid Rhinorrhea: A Tertiary Center Experience

Cerebrospinal Fluid Rhinorrhea: Causes, Sites, Management and Recurrence

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