title: Multilayered Closure of Cerebrospinal Fluid Rhinorrhea with Inlay Fascia Lata, Autologous Fat, and Outlay Fascia Lata: Our Experience.
abstract: OBJECTIVE
  Since the initial use in 1981 by Wigand, different endoscopic endonasal surgery techniques have been proposed to close ventral skull base defects, all of which include multilayer closure involving vascularized mucoseptal flaps, autologous grafts, and synthetic materials. These methods are used individually or in combination, as required by the operative condition.
  
  
  METHODS
  In this study we aimed to describe our endoscopic technique using inlay-outlay fascia lata and autologous fat with fibrin sealant to close spontaneous and traumatic cerebrospinal fluid (CSF) rhinorrhea.
  
  
  CONCLUSIONS
  Twenty-one CSF rhinorrhea patients were operated with this technique in our hospital. Two patients had large skull base defects and 15 patients had high-flow CSF leaks. We reached a 100% success rate in the first attempt without any long-term recurrence. Multilayered endoscopic closure with this technique offers satisfactory results with minimal morbidity even in large defects and high-flow CSF leaks.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Eryılmaz
authors.forename: Mitat
authors.initials: M
authors.lastname: Arıcıgil
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Alan
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D015331:Cohort Studies; D004724:Endoscopy / Q000379:methods*; D005206:Fascia Lata / Q000637:transplantation; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives