J Korean Neurotraumatol Soc.  2006 Jun;2(1):26-30. 10.13004/jknts.2006.2.1.26.

Endoscopic Endonasal Repair of Cerebrospinal Fluid Rhinorrhea by The Combined Overlay and Underlay Techniques

• Jung DS
• Jeon BC
• Park YS
• Oh HS

• KMID: 2192330
• DOI: http://doi.org/10.13004/jknts.2006.2.1.26

Abstract

OBJECTIVE
This study is aimed to describe the efficacy of endoscopic transnasal repair of cerebrospinal fluid (CSF) rhinorrhea and anterior skull base defect using a combined overlay and underlay techniques.
METHODS
The authors have performed 5 endoscopic procedures in the 3 patients with CSF rhinorrhea. The etiologies of the CSF leaks were 2 traumatic brain injuries and 1 iatrogenic one. All patients underwent preoperatively magnetic resonance imaging (MRI) scan with intrathecal infusion of Gadolinium. The repair using the overlay or combination technique was done with fibrin glue, strips of fat, and septal cartilage or porous polyethylene implant (Medpor).
RESULTS
All CSF leaks were found out during endoscopic procedures. One patient underwent an overlay technique using a rotated middle turbinate flap had recurrent CSF leakage, which was successfully treated with the combination technique. Other two patients exhibiting 3 CSF leakages were successfully treated with the combination techniques. Any major complication was not seen.
CONCLUSION
The endoscopic transnasal repair with free grafts by the combined overlay and underlay techniques is a safe and successful method for the treatment of CSF leaks.

Keyword

Cerebrospinal fluid rhinorrhea; Endoscopic surgery; Endonasal

MeSH Terms

Brain Injuries
Cartilage
Cerebrospinal Fluid Rhinorrhea*
Cerebrospinal Fluid*
Fibrin Tissue Adhesive
Gadolinium
Humans
Magnetic Resonance Imaging
Polyethylene
Skull Base
Transplants
Turbinates
Fibrin Tissue Adhesive
Gadolinium
Polyethylene