Endoscopic management of cerebrospinal fluid rhinorhea
Journal Title: Otolaryngologia Polska - Year 2009, Vol 63, Issue 4
Abstract
Endoscopic surgery due to its high effi cacy and relatively minor intraoperative trauma became a standard of transnasal csf leak treatment. The aim of this study: was to present, basing on our own experience, diagnostic and therapeutic methods of treatment of various types of csf rhinorhea. Material and method: All together 14 endoscopic skull base reconstructions were performed. The bony defect and dural perforations were closed using: fat grafts, septal bone or cartilage, mucosal flaps of the septum or nasal concha, artificial dura and collagen sponge with fibrin glue. The defect was localized by high resolution computed tomography, magnetic resonance cisternography, neuronavigation system and fluorecein test. Results: Complete closure of the defect and resolution of the csf leak after the first attempt was achieved in 92,3% of patients. In one case the rhinorhea was successfully stopped after the second reconstructive procedure. No adverse reaction of intrathecal fl uorescein administration were noted in our patients. Conclusions: Endoscopic surgeons have a wide variety of diagnostic tools and operative techniques at their disposal for precise localization and management of csf rhinorhea. The key for high effi cacy of the treatment is appropriate selection of diagnostic and surgical method depending on cause, type, size and localization of the leak.
Authors and Affiliations
Andrzej Sieśkiewicz, Tomasz Łysoń, Marek Rogowski, Zenon Mariak
Keywords
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