Endonasal Endoscopic Simultaneous Surgical Repair for Recurrent Multiple Traumatic Bilateral Cerebrospinal Fluid Rhinorrhea -
DOI:
https://doi.org/10.12970/2308-7978.2013.01.01.5Keywords:
Cerebrospinal fluid, enodonasal, endoscopic, head trauma, skull base, graft, recurrent.Abstract
Background: recurrent multiple traumatic cerebrospinal fluid (CSF) fistulas in the same patient are rare lesions. Although many skull base defects occur after trauma or surgery, otolaryngologists must be aware of the potential for multiple traumatic (CSF) fistulas Objectives/Hypothesis: We present our experience with this unusual condition and illustrating the endoscopic endonasal approach used with the technique of repair, the grafting material and surgical outcome. Methods:this is a retrospective study carried outin tertiary hospitals. Two males and a female patients with recurrent multiple traumatic bilateral cerebrospinal fluid rhinorrhea after road traffic accident (RTA) with previous unsuccessful surgery to repair the leak were investigated and operated on. Their medical history, rhinologic with enodonasal endoscipc examination, radiographic images, technique of repair, insertion of lumbar drain and postoperative follow up data were analyzed. Results:combined underlay and overlay techniques through endoscopic endonasal approach with the use of nasal turbinate tissue and temporary insertion of lumbar drain were effective for sealing the leaks for all patients. The follow up period were: 4 years in 2 patients and 3 years for the 3rd one. Conclusions:simultaneous surgical repair for recurrent multiple traumatic CSF fistulas can be safely and successfully done using combined underlay and overlay techniques through endoscopic endonasal approach in one sitting. In cases with traumatic CSF rhinorrhea (especially after RTA) it is mandatory to investigate for presence of multiple fistulas sites.References
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