Delayed cerebrospinal fluid rhinorrhea four years after gamma knife surgery for juvenile angiofibroma.
Juvenile angiofibroma (JA) is a highly vascularized tumor that often recurs or regrows. Recently, gamma knife surgery (GKS) was attempted on unresectable or remnant JA. We experienced a JA case that developed cerebrospinal fluid (CSF) rhinorrhea 4 years after GKS. Two surgical excisions using midfacial degloving approach were performed before GKS. After radiosurgery, the tumor was controlled, and no early complications were observed. However, 4 years after, intractable CSF leakage developed as a late complication, and we thus performed 4 subsequent endoscopic surgical repairs. The CSF leakage is very rare but can occur as a late complication of GKS and should be treated aggressively.
From the *Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine; and †Research Center for Human Natural Defense System, Yonsei University College of Medicine, Seoul, Korea.
Hyun Jin
HJ
Min
Hyo Jin
HJ
Chung
Chang-Hoon
CH
Kim
D050153:Abdominal Fat / Q000637:transplantation; D018322:Angiofibroma / Q000601:surgery*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D004621:Embolization, Therapeutic / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009297:Nasal Mucosa / Q000637:transplantation; D009303:Nasopharyngeal Neoplasms / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011183:Postoperative Complications; D016634:Radiosurgery / Q000379:methods*; D012008:Recurrence; D013101:Sphenoid Sinus / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult