Endonasal Endoscopic Closure of Cerebrospinal Fluid Rhinorrhea

S. Schmerber; Ch. Righini; J.-P. Lavieille; J.-G. Passagia; E. Reyt

doi:10.1055/s-2001-12787

Skull Base, Inhaltsverzeichnis

Skull Base 2001; 11(1): 047-058
DOI: 10.1055/s-2001-12787

Endonasal Endoscopic Closure of Cerebrospinal Fluid Rhinorrhea

S. Schmerber¹ , Ch. Righini¹ , J.-P. Lavieille¹ , J.-G. Passagia² , E. Reyt¹

¹Department of Ear, Nose, and Throat Surgery, Grenoble Hospital, Grenoble, France
²Department of Neurosurgery, Grenoble Hospital, Grenoble, France

Abstract

ABSTRACT

The authors review their experience with endoscopic repair of skull base defects associated with cerebrospinal fluid (CSF) rhinorrhea involving the paranasal sinuses. A total of 22 patients was treated endoscopically between 1992 and 1998. The repair method consisted of closure of the CSF fistula with a free autologous abdominal fat graft and fibrin glue, supported with a sheet of silastic. The primary closure rate was 82% (18/22), and the overall closure rate was 95.5% (21/22) without recurrence or complications within an average follow-up of 5 years (14-83 months). A single patient still complains of cerebrospinal rhinorrhea, although this was never proved by any clinical, endoscopic, or biological (β₂-transferrin) examination. The repair of ethmoidal-sphenoidal cerebrospinal fluid fistulae by endonasal endoscopic surgery is an excellent technique, both safe and effective. Fat is a material of choice, as it is tight and resists infection well. The technique and indications for endoscopic management of cerebrospinal fluid leaks are discussed.

KEYWORD

Cerebrospinal fluid rhinorrhea - fat graft - endoscopic treatment - anterior cranial fossa - ethmoid - sphenoidal sinus - MRI cisternography

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Referenzen

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