Neuroendoscopic Transnasal Repair of Cerebrospinal Fluid Rhinorrhea

Husain, Mazhar; Jha, Deepak Kumar; Vatsal, Devendra; Husain, Nuzhat; Gupta, Rakesh K.

doi:10.1055/s-2003-40596

Cited by 12 publications

(13 citation statements)

References 19 publications

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“…These results are in concurrence with the earlier reports discussed in literature. 3,4,6,10 Success rate of 100% was recorded in this study similar to the results published by Ismail et al 6 Hospital stay was less than 2 weeks in majority of cases. Mean follow up period was 12 months with no recurrence in any of these cases.…”

Section: Discussionsupporting

confidence: 88%

Trans-nasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a retrospective analysis

Singh

Kumar

Grewal

2018

Int J Otorhinolaryngol Head Neck Surg

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Background: The purpose of present study was to assess the management and surgical outcomes of trans-nasal endoscopic repair of CSF rhinorrhoea.Methods: A retrospective study was conducted on the basis of medical records of 8 patients (6 males and 2 females) who had undergone trans-nasal endoscopic reconstructive surgery for CSF leak in a tertiary care hospital. Data so collected was analyzed to determine the demographic and diagnostic factors with surgical outcomes. Rate of success achieved was also assessed. Results: Majority of patients were in the age group of 21-40 years with mean age of 28.50 years. Main cause of leak was trauma (75%) and most common site of defect was found to be the cribriform plate of ethmoid bone (75%). 38% patients suffered from recurrent episodes of meningitis. Repair of dehiscence was done by variety of graft material like fat, fascia, middle turbinate mucosa, septal bone, cartilage or mucosa and fibrin glue. Success rate of 100% was observed. No post-surgical complications were encountered in this series.Conclusions: Trans-nasal endoscopic surgical technique is an effective and atraumatic procedure for repair of CSF rhinorrhoea with minimum morbidity and low post-operative complications.

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Section: Discussionsupporting

confidence: 88%

Trans-nasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a retrospective analysis

Singh

Kumar

Grewal

2018

Int J Otorhinolaryngol Head Neck Surg

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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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“…Moreover the accessibility is poor due to adjacent neurovascular structures. The failure rate of craniotomy is as high as 20-40% [14] .…”

Section: Discussionmentioning

confidence: 99%

“…Many authors advocate continuous lumbar drainage after defect closure [14] . But we have observed that lumbar drain is required only for a high pressure leaks.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic Transnasal Repair of Cerebrospinal Fluid Rhinorrhea - Analysis of 400 Cases

Krishnan¹,

Vikram²,

Satish³

2016

OJOLHNS

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Objective: To describe our experience and outcome of transnasal endoscopic CSF leak repair in 400 patients. Materials and methods: It was a retrospective study of 400 cases operated over a period of 19 years. Results: 400 patients were reviewed. Of this, 62 % had spontaneous leaks and the rest of patients were found to have leak secondary to trauma. 6 cases were congenital. Age of the patients was between 30-50 years except congenital cases where majority were less than 10 years. CT Cisternography was our choice of radiological imaging, which had a success rate of 95% in detecting the defect. Most common CSF leak in our study was cribriform plate and the least was lateral recess or Sternberg's canal (1.5%). Our success rate in defect closure was 98% in the first attempt and 100% during the second attempt. Mean hospital stay was found to be 0.75 days. No major complications were encountered following the surgery. Conclusion: Our experience of endoscopic transnasal repair of CSF leaks is very good. Multi-layered closure is advocated. Hadad Bassagasteguy flap has been observed to be a good graft material. We urge the use of endoscopic repair due to better outcome and less morbidity.

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Neuroendoscopic Transnasal Repair of Cerebrospinal Fluid Rhinorrhea

Cited by 12 publications

References 19 publications

Trans-nasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a retrospective analysis

Trans-nasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a retrospective analysis

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

Endoscopic Transnasal Repair of Cerebrospinal Fluid Rhinorrhea - Analysis of 400 Cases

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