ENDOSCOPIC REPAIR OF CSF RHINORHEA

Elsayed, Mohamed; Abd-Elhady, Ibrahim; Ahmed Abd-Elbaset, Ahmed Abd-Elbaset

doi:10.21608/mjam.2012.16790

ENDOSCOPIC REPAIR OF CSF RHINORHEA

Document Type : Original Article

Authors

¹ ENT depart. Ahmed Maher Teaching Hospital

² ENT depart. Banha Teaching Hospital.

³ ENT depart. AL Azhar University.

10.21608/mjam.2012.16790

Abstract

Cerebrospinal fluid (CSF) rhinorrhea was first described by Galen, 200 B.C. Many attempts to correct a SF leak were done in the 20th Century, although the first well-succeeded surgical approach was attributed to Dandy in 1926, when he sutured the fascia lata over dural defect, on back of the posterior wall of the frontal sinus, by intracranial route. In1981, when Wigand repaired fistulas using an endoscope, this approach became widely adopted. Fluid leakage may be expressed by several symptoms and/or signs, although rhinorrhea is the most frequent one. In addition, presence of SF may be a risky condition for patient and onset of infections in the central nervous system, such as meningitis. Thus, in the absence of spontaneous resolution, a corrective procedure should be performed. Today, with improvements of skull base surgeries and the introduction of functional endoscopic surgery of paranasal sinuses in the otorhinolaryngology’s routine, there has been increased incidence of severe complications, such as the cerebrospinal fluid leakage 5. Thus, endonasal duraplasty has been successfully used to repair several dura mater lesions with low patient’s morbidity rate. Between 2001 and 2006, 12 patients with cerebrosp-inal rhinorrhea were operated on using intranasal endoscopic approach. The charts of all patients treated in our hospital were reviewed. Twelve patients, 7 women (58%) and 5 male (42%), were included in the study. Patients’ ages ranged from 18 to 58 years (mean: 39.3 years). Etiology, site of leakage, diagnosis, technique, cause of failure and follow-up are discussed. The authors concluded that transnasal endoscopic surgery for CSF rhinorrhea had high success rate, low morbidity and stable long-term results.