title: Basiespinal Cerebrospinal Fluid Leak as a Complication After Adenoidectomy: Case Report and Literature Review.
abstract: BACKGROUND
  Adenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). In turn, cerebrospinal fluid fistula is a very uncommon but critical complication in this type of surgery.
  
  
  METHODS
  We report the case of a 3-year-old patient who underwent adenoidectomy and presented a cerebrospinal fluid leak associated with pneumocephalus and meningitis.
  
  
  RESULTS
  The solution provided was a suture in layers of the fistula tract, reinforced with basipharyngeal vascularized and rotation random flap of mucosa, and a free graft of muscle, through a transoral endoscopic approach.
  
  
  CONCLUSIONS
  Cerebrospinal fluid leak as a complication after adenoidectomy is exceedingly rare. These pharyngospinal fistulae are determined by the anatomic features associated with intraoperative hemorrhagic complications, and it is essential that we take them into account when facing postoperative complications in the follow-up. The use of vascularized flaps based on the irrigation of the ascending pharyngeal artery with endoscopic techniques offers low-morbidity solutions, which are more efficient than traditional methods.
authors.affiliation: Rhinology Unit, Department of Otolaryngology, University Hospital Virgen Macarena, Sevilla, Spain. Electronic address: ramoluorl@gmail.com.
authors.forename: Ramón
authors.initials: R
authors.lastname: Moreno-Luna
authors.affiliation: Department of Neurosurgery, University Hospital Virgen del Rocío and Virgen Macarena, Sevilla, Spain.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Cárdenas Ruiz-Valdepeñas
authors.affiliation: Department of Otolaryngology, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Tato
authors.affiliation: Department of Neurosurgery, University Hospital Virgen del Rocío and Virgen Macarena, Sevilla, Spain.
authors.forename: Monica
authors.initials: M
authors.lastname: Rivero-Garvia
authors.affiliation: Department of Neurosurgery, University Hospital Virgen del Rocío and Virgen Macarena, Sevilla, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Márquez-Rivas
authors.affiliation: Department of Otolaryngology, University Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mochón Martín
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D065634:Cerebrospinal Fluid Leak / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D044583:Neuroendoscopy / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation*; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Adenoidectomy and complications; Cerebrospinal fluid; Craniocervical joint; Pedicle pharyngeal flap