Cerebrospinal fluid rhinorrhoea: an overview of endoscopic multilayer repair

Authors

  • Mohammed Shoeb Department of ENT, HBT Medical College, Mumbai, Maharashtra, India
  • Shashikant Mhashal Department of ENT, HBT Medical College, Mumbai, Maharashtra, India
  • Vinod Gite Department of ENT, HBT Medical College, Mumbai, Maharashtra, India
  • Samir Bhargava Department of ENT, HBT Medical College, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20163118

Keywords:

CSF rhinorrhoea, Endoscopic repair, Cisternography, Multilayer technique

Abstract

Background: A cerebrospinal fluid (CSF) rhinorrhoea occurs when there is communication between the subarachnoid space and the nasal cavity. CSF rhinorrhoea commonly occurs following head trauma (fronto-basal skull fractures), as a result of intracranial surgery or spontaneously. The aim of our article was to emphasize the importance of endonasal endoscopic surgery using multilayer autograft technique.

Methods: A total of 08 cases of CSF rhinorrhoea were treated. A retrospective study was undertaken to analyze the characteristics of 08 patients. After detailed otorhinolaryngoscopic examination, diagnostic nasal endoscopy and radiological evaluation by CT and MRI, all underwent endonasal endoscopic surgery. This article reviews the causes, diagnosis and treatment of CSF leakage of cases done with a 0 degree 4 mm sinoscope using fascia lata septal cartilage and fat as a graft material.  

Results: The defects as large as 1.5 cm could be safely treated with this technique. The overall success rate of endoscopic repair for CSF rhinorrhoea has been 100%.

Conclusions: Endonasal approach is less morbid compared with external approach. Endoscopic surgery gives better visualization.

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References

Calcaterra TC, Moseley JI, Rand RW. Cerebrospinal rhinorrhea: extracranial surgical repair. West J Med. 1977;127:279-83.

Lanza DC, Brien DA, Kennedy DW. Endoscopic repair of cerebrospinal fluid fistulae and encephaloceles. Laryngoscope. 1996;106:1119-25.

King D. Report to Westminster Medical Society. Lond. Med Surg J. 1834;4:823-5.

Mullar C. Case of hydrocephalus chronicus, with some unusual symptoms and appearances on dissection. Trans Med Chir Soc Edinb. 1826;2:243-8.

Stankiewicz JA. Cerebrospinal fluid fistula and endoscopic sinus surgery. Laryngoscope. 1991;101:250-6.

Papay FA, Benninger MS, LevineHL. Transnasal transseptal endoscopic repair of sphenoidal cerebrospinal fluid fistula. Otolaryngol Head Neck Surg. 1989;101:595-7.

Thompson C. The cerebrospinal fluid: its spontaneous escape from the nose. London: Cassell. 1899.

Cairns H. Injuries of the frontal and ethamoidal sinus with special reference to cerebrospinal fluid rhinorrhea and aerocele. J Laryngol Otol. 1937;52:589-623.

Endonasal endoscopic closure of cerebrospinal fluid rhinorrhea. Available at http:// www.ncbi.nlm.nih.gov/pmc/articles/PMC1656831/pdf/skullbase00005-0046.pdf. Accessed on 29 May 2016.

Banhawy OA, Halaka AN, Hafiz SEDA, Ayad H. Subcranial transnasal repair of cerebrospinal fluid rhinorrhea with free autologous grafts by the combined overlay and underlay techniques. Minim Invasive Neurosurg. 2004;47(4):197-202.

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Published

2016-09-26

How to Cite

Shoeb, M., Mhashal, S., Gite, V., & Bhargava, S. (2016). Cerebrospinal fluid rhinorrhoea: an overview of endoscopic multilayer repair. International Journal of Otorhinolaryngology and Head and Neck Surgery, 2(4), 180–183. https://doi.org/10.18203/issn.2454-5929.ijohns20163118

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Original Research Articles