![]() ![]() In cases where the leak had stopped we relied on high resolution CT scan and CT cisternography to determine the leak and location. Preoperatively patients underwent various evaluations to confirm CSF leak and location, including thorough history and physical with nasal endoscopy and testing including magnetic resonance imaging (MRI), computed tomography (CT), β-trace testing and β-2 transferrin testing for confirmation of CSF rhinorrhea (a protein found almost exclusive in CSF, perilymph in the cochlea and the aqueous and vitreous humor of the eye, so it has high sensitivity and specificity, and have high false-positive rate in cases of cirrhosis or hereditary protein anomalies). The study was approved by the University Hospital Complex of Santiago de Compostela (CHUS) medical ethics board. We will consider the 30 patients who underwent repair CSF leaks by ESS. ![]() Data were collected according to the patient’s characteristics, CSF fistula, surgical techniques, materials used to repair the defect, and complications. ![]() Retrospective chart review was performed of all patients surgically treated for CSF leaks of the anterior skull base presenting to the Section of Nasal and Sinus Disorders at the Service of ENT-Head and Neck Surgery, University Hospital Complex of Santiago de Compostela (CHUS), between 20. The aim of this article is to consider our experience and to evaluate the outcomes in patients who underwent a purely endoscopic repair of CSF leaks of the anterior skull base. Etiology affects the risk of recurrence and thus the method of repair by having an impact on the defect size, location, degree of dural involvement, the likelihood of elevated intracranial pressure (ICP), and the possibility of meningoencephalocele protrusion. EES is a minimally invasive surgical technique, which provided a direct short-cut access to anterior and middle skull base without traversing any mayor neurovascular structures, which until recently accounted for a significant morbidity and a high-risk surgery and CSF fistula is now one of its well-established indications.ĬSF leaks can have many etiologies including spontaneous, tumor-related, traumatic (accidental or iatrogenic), or congenital leaks. ĮSS has become a common otolaryngologist procedure. Evaluation of the endoscopic repair of sinonasal CSF leaks has shown high success rates of 90% for first attempts at repair and up to 97% following a second endoscopic repair. And any persistent CSF leak should be repaired. CSF leaks bears the risk of meningeal or intracranial infection and complication. Approximately 90% of CSF leaks at the anterior skull base manifests as rhinorrhea and can become life-threatening condition. ![]() The challenge is to recreate the barrier between the cranial vault and the nasal cavity to prevent and eliminate cerebrospinal fluid (CSF) leaks and protect the brain from exposure to infectious sources. CSF leaks of the anterior skull base present one of the more difficult challenges in Endonasal edoscopic surgery (EES), involving an area that is anatomically complicated and technically demanding to access. It is generally accepted that the ESS have made procedures minimally invasive, and CSF leak is now one of its well-established indications with low morbidity and high success rate, with one restriction for fistulas of the posterior wall of the frontal sinus should be repaired in conjunction with open techniques.Ĭerebrospinal fluid leaks (CSF) result from an abnormal communication between the subarachnoid space and the extracranial space. Identifying the size, site, and etiology of the CSF leak remains the most important factor in the surgical success. Follow-up periods ranged from 4 months to 6 years. The success rate was 93.4% at the first attempt only two patients (6.6%) required a second surgical procedure, and none of it was necessary to use a craniotomy for closure. A total of 30 patients who underwent repair CSF leak by ESS. Retrospective chart review was performed of all patients surgically treated for CSF leaks presenting to the Section of Nasal and Sinus Disorders at the Service of ENT–Head and Neck Surgery, University Hospital Complex of Santiago de Compostela (CHUS), between 20. Endoscopic sinus surgery (ESS) has become a common otolaryngologist procedure. Approximately 90% of CSF leak at the anterior skull base manifests as rhinorrhea and can become life-threatening condition. Cerebrospinal fluid leaks (CSF) result from an abnormal communication between the subarachnoid space and the extracranial space. ![]()
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