[Endoscopic management of cerebrospinal fluid rhinorhea].
Endoscopic surgery due to its high efficacy and relatively minor intraoperative trauma became a standard of transnasal csf leak treatment.


OBJECTIVE
was to present, basing on our own experience, diagnostic and therapeutic methods of treatment of various types of csf rhinorhea.


METHODS
All together 14 endoscopic skull base reconstructions were performed. The bony defect and dural perforations were closed using: fat grafts, septal bone or cartilage, mucosal flaps of the septum or nasal concha, artificial dura and collagen sponge with fibrin glue. The defect was localized by high resolution computed tomography, magnetic resonance cisternography, neuronavigation system and fluorecein test.


RESULTS
Complete closure of the defect and resolution of the csf leak after the first attempt was achieved in 92,3% of patients. In one case the rhinorhea was successfully stopped after the second reconstructive procedure. No adverse reaction of intrathecal fluorescein administration were noted in our patients.


CONCLUSIONS
Endoscopic surgeons have a wide variety of diagnostic tools and operative techniques at their disposal for precise localization and management of csf rhinorhea. The key for high efficacy of the treatment is appropriate selection of diagnostic and surgical method depending on cause, type, size and localization of the leak.
Sieśkiewicz
Andrzej
A
Klinika Otolaryngologii Uniwersytetu Medycznego W Białymstoku. sieska@interia.pl
Łysoń
Tomasz
T
Rogowski
Marek
M
Mariak
Zenon
Z
D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D005004:Ethmoid Bone / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D008866:Microsurgery / Q000379:methods; D009296:Nasal Cavity / Q000601:surgery*; D009297:Nasal Mucosa / Q000637:transplantation; D009300:Nasal Septum / Q000637:transplantation; D044583:Neuroendoscopy / Q000379:methods*; D011044:Poland; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive