title: Closure of clival cerebrospinal fluid fistula with biocompatible osteoconductive polymer.
abstract: Cerebrospinal fluid fistula into the upper airway often results in meningitis. Closure of fistulas is usually effective using conventional surgical techniques to reconstruct the defect. We report a case of cerebrospinal fluid fistula into the sphenoid sinus and nasopharynx secondary to resection of a clivus chordoma that resisted conventional attempts at closure, including a rectus abdominus free flap. Closure of the fistula was accomplished with the use of a novel alloplast, biocompatible osteoconductive polymer. Follow-up for more than 1 year shows no evidence of rejection, infection, or recurrent cerebrospinal fluid rhinorrhea.
authors.affiliation: Washington University, St. Louis, Mo.
authors.forename: G A
authors.initials: GA
authors.lastname: Gates
authors.forename: G O
authors.initials: GO
authors.lastname: Sertl
authors.forename: R L
authors.initials: RL
authors.lastname: Grubb
authors.forename: F J
authors.initials: FJ
authors.lastname: Wippold
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D001847:Bone Diseases / Q000209:etiology / Q000601:surgery; D002555:Cerebrospinal Fluid; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery; D002817:Chordoma / Q000601:surgery; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates; D011183:Postoperative Complications; D011205:Povidone; D019736:Prostheses and Implants; D012888:Skull Neoplasms / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery*
chemical_list: D001672:Biocompatible Materials; D008768:Methylmethacrylates; C037334:poly(methylmethacrylate-N-vinylpyrrolidone); D011205:Povidone