Sphenoid sinus cerebrospinal fluid leaks

Spontaneous cerebrospinal fluid leaks

“…In this subset of patients, the rate of successful closure is reportedly abysmal when compared with other causes with recurrences reported to be anywhere from 25 to 87% over time [6][7][8]. Fortunately, our comprehension of the pathophysiology underlying spontaneous CSF leaks has improved dramatically over the last decade [1,2,[7][8][9][10][11]. Successful long-term outcomes in this subset of CSF leaks are dependent upon both operative closure and management of intracranial hypertension.…”

“…Traditionally closed via a frontal craniotomy approach, skull base defects are now repaired with success rates of over 90% using transnasal endoscopic techniques [1][2][3][4][5]. Most CSF leaks can be broadly characterized according to the underlying causes, including traumatic (including accidental and iatrogenic trauma), tumor, spontaneous, and congenital causes; however, the spontaneous CSF leak category (sometimes called 'idiopathic') has traditionally been designated for leaks without an identifiable cause.…”

Endoscopic Coblator™‐assisted management of encephaloceles

“…There were no changes in the routine care of patients. Intrathecal fluorescein was administered through lumbar puncture in all patients to aid in localization according to previously described protocol5, 6, 9, 10, 17, 18. Lumbar drains were left in place throughout the operation.…”

“…Surgical technique usually involves meticulous monopolar or bipolar cautery to decrease the potential for intracranial bleeding during removal. Once the encephalocele is removed, the site is prepared and reconstructed with a variety of grafting methods that may include bone and fascial grafts 9–11. New technologies are continually developed in an effort to improve operating efficiency without a decrease in safety.…”

Complications of Skull Base Reconstruction

“…Success rates for endoscopic skull base defect repair are commonly greater than 90% in most series, but decrease with large defect size following tumor extirpation [10,[58][59][60][61][62][63][64]. The development and utility of vascularized nasoseptal flaps and other variations of pedicled local reconstructive techniques have been a critical factor in improving success rates for large anterior cranial base defects and high-flow CSF leaks.…”