Skip to main content
Log in

Transnasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea: An Analysis of 22 Cases

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The purpose of this study was to investigate and summarize the surgical procedure and efficacy of transnasal endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea. This is a retrospective study including 22 patients with CSF rhinorrhea who underwent transnasal endoscopic repair between January 2003 and August 2010. The location of the lesion was determined by both HRCT scan and intranasal endoscopy, and the lesion was repaired with a graft from autologous thigh muscle fascia. The grafts were placed and fixed above (inlay) or beneath (onlay) the lesions or defects. The causes of CSF rhinorrhea in our study included trauma, surgical injury, and meningoencephalocele, or idiopathic etiology. There were 15 of 17 patients with histories of trauma or surgical injury who were found to have defects in skull base by HRCT examination. The other 5 patients had an intact skull base, minor local osteoporosis, or bone resorption. All 22 patients had no reoccurrence of CSF rhinorrhea during the follow-up period, which ranges from 4 to 72 months. The transnasal endoscopic approach is a safe and effective procedure, with minimal invasion, for the repair of CSF rhinorrhea.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Giddings NA, Brackmann DE (1994) Surgical treatment of difficult cerebrospinal fluid otorhinorrhea. Am J Otol 15:781–784

    PubMed  CAS  Google Scholar 

  2. Marshall AH, Jones NS, Robertson IJ (2001) CSF rhinorrhoea: the place of endoscopic sinus surgery. Br J Neurosurg 15:8–12. doi:10.1080/02688690020024319

    Article  PubMed  CAS  Google Scholar 

  3. Wigand WE (1981) Transnasal ethmoidectomy under endoscopic control. Rhinology 9:7

    Google Scholar 

  4. Hegazy HM, Carrau RL, Snyderman CH, Kassam A, Zweig J (2000) Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: a meta-analysis. Laryngoscope 110:1166–1172. doi:10.1097/00005537-200007000-00019

    Article  PubMed  CAS  Google Scholar 

  5. Lanza DC, O’Brien DA, Kennedy DW (1996) Endoscopic repair of cerebrospinal fluid fistulae and encephaloceles. Laryngoscope 106:1119–1125

    Article  PubMed  CAS  Google Scholar 

  6. Lee TJ, Huang CC, Chuang CC, Huang SF (2004) Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea and skull base defect: ten-year experience. Laryngoscope 114:1475–1481. doi:10.1097/00005537-200408000-00029

    Article  PubMed  Google Scholar 

  7. Lindstrom DR, Toohill RJ, Loehrl TA, Smith TL (2004) Management of cerebrospinal fluid rhinorrhea: the Medical College of Wisconsin experience. Laryngoscope 114:969–974. doi:10.1097/00005537-200406000-00003

    Article  PubMed  Google Scholar 

  8. Farooq MU, Ansari MA (2011) Cerebrospinal fluid rhinorrhea: etiology, site of leakage and endoscopic management. J Coll Phys Surg Pak 21:460–463. doi:08.2011/JCPSP.460463

    Google Scholar 

  9. Wormald PJ, McDonogh M (1997) Bath-plug’ technique for the endoscopic management of cerebrospinal fluid leaks. J Laryngol Otol 111:1042–1046. doi:10.1017/S0022215100139295

    Article  PubMed  CAS  Google Scholar 

  10. Park JI, Strelzow VV, Friedman WH (1983) Current management of cerebrospinal fluid rhinorrhea. Laryngoscope 99:1195–1201

    Google Scholar 

  11. Liu P, Wu S, Li Z, Wang B (2010) Surgical strategy for cerebrospinal fluid rhinorrhea repair. Neurosurgery 66(6 Suppl Operative):281–285. doi:10.1227/01.NEU.0000369660.30126.02

    PubMed  Google Scholar 

  12. Zapalac JS, Marple BF, Schwadae ND (2002) Skull base cerebrospinal fluid fistulas: a comprehensive diagnostic algorithm. Otolaryngol Head Neck Surg 126:669–676. doi:10.1067/mhn.2002.125755

    Article  PubMed  Google Scholar 

  13. Gulcek SY, Erdogan A, Toprak U, Ortac AA, Pasaoglu E (2003) Evaluation of rhinorrhea by computed tomography cisternography. Tani Girisim Radyo l9:327–332

    Google Scholar 

  14. Shetty PG, Shroff MM, Sahani DV, Kirtane MV (1998) Evaluation of high-resolution CT and MR cisternography in the diagnosis of cerebrospinal fluid fistula. AJNR Am J Neuroradio 19:633–639

    CAS  Google Scholar 

  15. Hegarty SE, Millar JS (1997) MRI in the localization of CSF fistulae: is it of any value? Clin Radiol 52:768–770

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yong-Gang Kong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kong, YG., Deng, YQ. & Wang, Y. Transnasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea: An Analysis of 22 Cases. Indian J Otolaryngol Head Neck Surg 65 (Suppl 2), 409–414 (2013). https://doi.org/10.1007/s12070-013-0628-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-013-0628-8

Keywords

Navigation