[Endoscopic closure of cranionasal cerebrospinal fluid fistulas with the use of neuronavigation--"Computer Aided Surgery"].
BACKGROUND
Conventionally, cranionasal cerebrospinal fluid (CSF) fistulas have been closed by repair of the dural defect via an open craniotomy. These techniques may be cumbersome, not without complications, and far from successful. In recent years, endoscopic techniques have been developed in the field of nasal surgery and neurosurgery. Furthermore, by means of computer-aided surgery or neuronavigation, it is possible to identify the surgical track with a high degree of accuracy and, by the same token, identify the defect in the cranium.


METHODS
By combining the endoscopic technique with computer-aided surgery, we have operated on six patients with cranionasal CSF fistulas endonasally. The fistula was confirmed before surgery by subaracnoidal injection of fluorescein.


RESULTS
The surgery was successful and without any complications in all six cases.


CONCLUSIONS
The method is recommended as the operation of first choice for cranionasal CFS fistulas, as compared to transcranial surgery. It is probably more efficient and with fewer complications than conventional surgery. A collaboration between neurosurgeons and ENT surgeons, like ours, can be recommended.
Kosteljanetz
M
M
H:S Rigshospitalet, Neurocentret, neurokirurgisk afdeling, HovedOrtoCentret, øre-naese-hals-kirurgisk klinik. doktormk@rh.dk
von Buchwald
C
C
Poulsgård
L
L
Rasmussen
N
N
Wagner
A
A
D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010256:Paranasal Sinuses / Q000601:surgery; D013813:Therapy, Computer-Assisted / Q000379:methods*
Endoskopisk lukning af kranionasale liquorfistler med anvendelse af neuronavigation--"Computer Aided Surgery".