title: Management of sphenoid sinus cerebrospinal fluid rhinorrhea: making use of an extended approach to the sphenoid sinus.
abstract: OBJECTIVE
  Specific information addressing the management of cerebrospinal fluid (CSF) fistulas that originate from within the sphenoid sinus remains scant. The objective of this study was to review the cause and management of CSF rhinorrhea arising from the sphenoid sinus.
  
  
  METHODS
  This is a retrospective chart review of 12 cases of CSF rhinorrhea arising from the sphenoid sinus that occurred in 11 patients. All patients were treated at a single institution between 1994 and 1999.
  
  
  RESULTS
  All patients were managed surgically with sphenoid sinus fat obliteration using an endoscopic sublabial, transseptal approach. This approach was successful for all 12 cases, with median duration of follow-up of 18 months.
  
  
  CONCLUSIONS
  Endoscopically assisted transseptal repair of CSF fistulas that originate within the sphenoid sinus offers an alternate approach to previously described methods of repair in this region. Advantages include wide access to the entire sphenoid sinus, improved access to laterally pneumatized regions within the sphenoid sinus, and rostral mucosal closure over the repair within the sinus.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas 75390-9035, USA.
authors.forename: Neelesh H
authors.initials: NH
authors.lastname: Mehendale
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Marple
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed