Application of the Mimic Valsalva Maneuver with the Help of a Saccule in Cerebrospinal Fluid Rhinorrhea Reconstruction Surgery.
OBJECTIVE
To explore the mimic Valsalva maneuver with the help of a saccule handled by an anesthesiologist in order to locate the leakage channel and repair the fistula during intranasal endoscopic reconstruction surgery of cerebrospinal fluid rhinorrhea.


METHODS
From 2012 to 2014, 8 patients were diagnosed with cerebrospinal fluid rhinorrhea by medical histories, physical and biochemical examination. All patients were treated with intranasal endoscopic reconstruction surgery of cerebrospinal fluid rhinorrhea. During the surgery, the mimic Valsalva maneuver with the help of a saccule was carried out once or twice by an anesthetist during the operation. Intranasal endoscopy was used to accurately locate the leakage site as shown by the exact fistula. Temporal fascia, fascia lata, middle turbinate mucosa and nasal septum mucosa were all used to repair the fistula.


RESULTS
After the surrounding mucosa was removed, the exact leakage sites were accurately found. Fascia materials were used in all 8 patients. All patients were successfully treated after their first operation, and 1 patient was successfully treated by two operations with no complications and recurrences. All the patients were followed up for 1 month to 2 years.


CONCLUSIONS
The convenient method of the mimic Valsalva maneuver with the help of a saccule handled by an anesthesiologist has a good prospect in cerebrospinal fluid rhinorrhea reconstruction surgery.
Medical School of Ningbo University, Ningbo, China.
Peng
P
Cheng
Shi-Xiong
SX
Tang
Jing
J
Qing
Yao-Wen
YW
Wang
Shou-Guo
SG
Yao
Tian-Bin
TB
Ouyang
De-Qiu
DQ
Kong
D000293:Adolescent; D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009666:Nose; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012444:Saccule and Utricle / Q000000981:diagnostic imaging*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014636:Valsalva Maneuver / Q000502:physiology*; D055815:Young Adult