Unilateral Endoscopic Approach for Repair of Frontal Sinus Cerebrospinal Fluid Leak

Roehm, Corrie E.; Brown, Seth M.

doi:10.1055/s-0031-1275241

Cited by 13 publications

(10 citation statements)

References 13 publications

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“…Although the transnasal endoscopic modified Lothrop or Draf III procedure improved the treatment of FS-CSFR, its use has been limited due to its more severe surgical injury to the transnasal structure and more difficult surgery 9. Given the deficiency of transnasal endoscopic approach and the aggressive open surgery, some cases of FS-CSFR may benefit more from repair via the combined intra–extranasal approach 10,11…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers have proposed using individualized surgical approach to treat these different types of CSFR 13. Our experience indicates that CSFR adjacent to the frontal recess or inside the recess should be treated with the transnasal endoscopy since it will limit the complications to the minimum 11. On the other hand, CSFR involved in the frontal posterior table can be classified into two types based on their relationship to the plane of the lamina papyracea (Figure 6).…”

Section: Discussionmentioning

confidence: 99%

“… 9 Given the deficiency of transnasal endoscopic approach and the aggressive open surgery, some cases of FS-CSFR may benefit more from repair via the combined intra–extranasal approach. 10 , 11 …”

Section: Discussionmentioning

confidence: 99%

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Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Yang

Huang

Wang

et al. 2017

TCRM

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The aim of this study was to summarize and analyze the outcomes of frontal sinus cerebrospinal fluid rhinorrhea (FS-CSFR) treated by transnasal endoscopic and combined intra–extranasal approach. Clinical data on 20 cases of FS-CSFR patients from 2005 to 2013, with emphasis on the postoperative complications, clinical outcomes, and key technology involved in the combined intra–extranasal procedure, were retrospectively reviewed. Among the 20 cases, 12 were treated by combined intra–extranasal procedure; the other eight cases were initially treated by trans-nasal endoscopic approach alone, and five of them (5/8, 62.5%) were successfully treated and three failed. The three failed cases subsequently underwent combined intra–extranasal approach. A total of 15 cases, who received combined procedure, experienced fast recovery, had mild complications, and had no significant facial scars, and no CSFR recurrence was observed. Combined intra–extranasal approach offers advantages in not only overcoming the difficulty of insufficient exposure of defects during transnasal endoscopic procedure but also improving the success rate of repair.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Yang

Huang

Wang

et al. 2017

TCRM

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“…Despite the advancement in the technique of repair, a leak from the posterior wall of frontal sinus especially extending laterally still remains a daunting task via the transnasal endoscopic approach and usually requires an open approach. [ 5 6 ]…”

Section: Discussionmentioning

confidence: 99%

Purely endoscopic pterional extradural approach: A novel technique for repair of cerebrospinal fluid rhinorrhea

Sinha

Goyal

2016

Journal of Neurosciences in Rural Practice

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Study Design:Retrospective descriptive study of an innovative surgical technique.Objective:To assess the feasibility and success of repair of transfrontal sinus cerebrospinal fluid (CSF) rhinorrhea through pterional transcranial extradural approach using endoscope.Summary of Background Data:Repair of CSF rhinorrhea has seen advancement with the evolution of endoscopic transnasal techniques. However, leaks from defect in the posterior wall of frontal sinus still remain a challenge for the skull base surgeons and requires conventional craniotomy more often. We describe a novel technique to repair these leaks by purely endoscopic pterional extradural (PEPE) approach thereby avoiding complications associated with conventional craniotomy and endoscopic transnasal approaches.Materials and Methods:Thirty-five patients with traumatic CSF rhinorrhea from the posterior wall of frontal sinus underwent repair with the present technique. They were followed up for 6–18 months and were evaluated for feasibility of procedure, recurrence of leak, and occurrence of the fresh neurological deficit.Results:Thirty-five patients underwent CSF rhinorrhea repair using the above technique. The procedure was accomplished in all patients without any intraoperative complications. There was no requirement of blood transfusion in any case. All patients had a cessation of CSF leak in the postoperative period, and there was no recurrence. There was no evidence of frontal lobe retraction injury in any of these patients, and no fresh neurological deficit was observed.Conclusion:This PEPE approach to repair CSF leak through the posterior wall of the frontal sinus is a novel technique in which we can avoid disadvantages associated with both conventional craniotomy as well as transnasal endoscopic approaches.

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“…11 The unilateral endoscopic approach for repair of frontal sinus CSF leak in four cases was described by Roehm and Brown in which single-stage repair could be performed in three cases. 12 Endoscopic-assisted trephination approach for repair of frontal sinus cerebrospinal fluid leaks has been described where a frontal trephine was made and the endoscope was introduced through it. CSF leak of frontal sinus origin was then repaired.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Technique for Repairing CSF Leaks Due to Defects of Posterior Table of Frontal Sinus

et al. 2014

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Objective?Cerebrospinal fluid (CSF) leaks from the frontoethmoid and sphenoid region can be easily dealt with endoscopic approaches, but CSF rhinorrhea due to frontal sinus fractures are difficult to treat solely by the nasal endoscopic approach and may require external repair. The technique described targets defects of the posterior table of the frontal sinus where conventional osteoplastic approach of obliteration is usually done. This technique is minimally invasive and involves repair using an endoscope via a frontal trephine. Methods?We have treated five cases of traumatic CSF rhinorrhea with this technique, and the mean follow-up is 1?year (range: 10?14 months). The frontal sinus is opened by making a small stab incision (frontal trephine), and the defect site is localized by visualization via endoscope through the trephine. The repair is then performed with fat, bone graft, and fibrin glue. Results?Closure of the defect was achieved in a single stage in all the patients, and none of them had a recurrence of leak in the 1-year follow-up period. Conclusion?This is a good technique for superiorly and laterally placed posterior table defects of the frontal sinus with minimal morbidity and excellent closure rates.

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Unilateral Endoscopic Approach for Repair of Frontal Sinus Cerebrospinal Fluid Leak

Cited by 13 publications

References 13 publications

Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Purely endoscopic pterional extradural approach: A novel technique for repair of cerebrospinal fluid rhinorrhea

Minimally Invasive Technique for Repairing CSF Leaks Due to Defects of Posterior Table of Frontal Sinus

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Unilateral Endoscopic Approach for Repair of Frontal Sinus Cerebrospinal Fluid Leak

Cited by 13 publications

References 13 publications

Transnasal endoscopic and combined intra&ndash;extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Transnasal endoscopic and combined intra&ndash;extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Purely endoscopic pterional extradural approach: A novel technique for repair of cerebrospinal fluid rhinorrhea

Minimally Invasive Technique for Repairing CSF Leaks Due to Defects of Posterior Table of Frontal Sinus

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Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea