title: Double seal technique to obliterate the eustachian tube orifice: a novel method for the treatment of recalcitrant cerebrospinal fluid leak.
abstract: OBJECTIVE
  To demonstrate a novel and effective surgical technique for the treatment of refractory cerebrospinal fluid rhinorrhoea after skull base surgery. The novel surgical technique is described and the findings of a review of relevant world English-language publications are reported.
  
  
  METHODS
  A 44-year-old woman, otherwise fit and well, presented with more than a 2-year history of right-sided facial pain. A diagnosis of classical trigeminal neuralgia was made. Surgical treatment was undertaken with a retromastoid suboccipital craniotomy. Post-operatively, the patient showed signs of right-sided cerebrospinal fluid rhinorrhoea which was recalcitrant. In light of a continuous leak and several hospital admissions, a novel technique was performed whereby the eustachian tube orifice was obliterated using an endonasal endoscopic approach. The technique proved to be successful, with no further leakage.
  
  
  CONCLUSIONS
  Endoscopic obliteration of the eustachian tube using a double seal technique is a simple, safe and effective procedure in the treatment of a refractory cerebrospinal fluid leak.
authors: Department of Otolaryngology,Head and Neck Surgery,Charing Cross Hospital,London Imperial College Healthcare NHS Trust,UK.
authors: A S
authors: AS
authors: Taghi
authors: Department of Otolaryngology,Head and Neck Surgery,Charing Cross Hospital,London Imperial College Healthcare NHS Trust,UK.
authors: M
authors: M
authors: Bentley
authors: Department of Otolaryngology,Head and Neck Surgery,Charing Cross Hospital,London Imperial College Healthcare NHS Trust,UK.
authors: R
authors: R
authors: Kuchai
authors: Department of Otolaryngology,Head and Neck Surgery,Charing Cross Hospital,London Imperial College Healthcare NHS Trust,UK.
authors: H A
authors: HA
authors: Saleh
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D003399:Craniotomy; D004724:Endoscopy; D005064:Eustachian Tube / Q000601:surgery*; D005260:Female; D006801:Humans; D009296:Nasal Cavity; D011183:Postoperative Complications / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000601:surgery*
keywords: CSF Rhinorrhea; Eustachian Tube