Transnasal endoscopic treatment of cerebrospinal fluid leak: 17 years' experience.
Aim of this report is to describe the long-term results of endoscopic endonasal repair of cerebrospinal fluid leak using a septal mucoperichondrial graft. A case series of 52 patients operated for cerebrospinal fluid rhinorrhea between 1990 and 2006 is presented. All patients underwent surgical treatment for endoscopic endonasal closure of a cerebrospinal fluid leak using a septal mucoperichondrial graft. No lumbar drain and fluorescein tests were used. The intra-operative localization of the fistula was aided by Valsalva's manoeuvre by the anaesthetist. The success rate, after the first attempt, was 88.5% (46/52 patients); for the remaining 11.5% (6/52 patients), a second attempt was necessary which proved successful in 5 cases, raising the overall success rate to 98.1% (51/52 patients). Relapse occurred in only one case (1.9%), after the second attempt. In conclusion, a free mucoperichondrial graft offered good results for cerebrospinal fluid leak repair. In the Authors' experience, a high success rate can be achieved without the use of intrathecal fluorescein and lumbar drain.
Presutti
L
L
Department of Otolaryngology, University Hospital of Modena, Modena, Italy.
Mattioli
F
F
Villari
D
D
Marchioni
D
D
Alicandri-Ciufelli
M
M
D000293:Adolescent; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005402:Fistula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D009300:Nasal Septum / Q000637:transplantation*; D009666:Nose; D010911:Pituitary Neoplasms / Q000601:surgery; D011183:Postoperative Complications; D012720:Severity of Illness Index; D012852:Sinusitis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D014636:Valsalva Maneuver; D055815:Young Adult