Endoscopic management of cerebrospinal fluid rhinorrhea from anterior skull base defects

Authors

  • Ahmad Daneshi Department of Otorhinolaryngology-Head & Neck Surgery, Hazrat-e Rasool Hospital, Iran University of Medical Sciences.
  • Mohammad Farhadi Department & Research Center of Otorhinolaryngology-Head & Neck Surgery, Hazrat-e Rasool Hospital.
  • Saleh Mohebbi Head and Neck Surgery, Shahid Mohammadi Hospital(Bandar Abbas).
  • Shabahang Mohammadi Department of Otorhinolaryngology-Head & Neck Surgery, Hazrate-e-
Abstract:

  Abstract   Background: Over the past 20 years, the minimally invasive endoscopic approach   has gained widespread acceptance. The study was performed to evaluate the   diagnostic method and the success rate of endoscopically diagnosed and treated CSF   rhinorrhea, and also investigations such as leakage site and etiologic factor.   Methods: This retrospective CSF leakage management review of patients experiencing   CSF rhinorrhea made from 1999-2006 included data regarding leakage etiology,   preoperative assessment, intraoperative techniques and postoperative followup.   Result: Sixty-five patients were managed endoscopically. CSF rhinorrhea etiology   was traumatic in 30 cases, iatrogenic in 23 and spontaneous in 12. We used nasal   endoscopy and high resolution computed tomography (HRCT) in all 65 cases while   CT metrizamide cisternography was used in 5 specifically and magnetic resonance   imaging for 5 others. Intrathecal fluorescein was used for intraoperative assessment   without complications, and only one case of meningismus was noted.   Conclusion: Several imaging methods were effective in diagnosing CSF leakage   sites. Endoscopic management and autografts were successful in repairing anterior   skull defects in 90.76% of the cases.

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Journal title

volume 22  issue 1

pages  12- 16

publication date 2008-05

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