Management of acute intraoperative cerebrospinal fluid leaks

Four locations for congenital cerebrospinal fluid fistula in the region of a normal labyrinth are reviewed. A congenital leak may occur through the petromastoid canal, a wide cochlear aqueduct, Hyrtl's fissure, or the facial canal. A fistula through the initial segment of the fallopian canal was successfully repaired in a two-year-old boy who had three episodes of meningitis following otitis media. Knowledge of these four sites of congenital defects provides a guideline for the surgeon in the identification and repair of cerebrospinal fluid leaks in the region of the labyrinth.

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Body Mass Index and Imaging Abnormalities in Spontaneous Cerebrospinal Fluid Leaks of the Temporal Bone

Otolaryngology ◽

10.1177/0194599814541627a160 ◽

2014 ◽

Vol 151 (1_suppl) ◽

pp. P80-P80

Author(s):

Andrew M. Rivera ◽

Daniel Jethanamest ◽

Simon I. Angeli

Keyword(s):

Body Mass Index ◽

Cerebrospinal Fluid ◽

Temporal Bone ◽

Body Mass ◽

Cerebrospinal Fluid Leaks

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Complications of Extended Endoscopic Endonasal Surgery in Elderly Patients

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1625948 ◽

2018 ◽

Vol 79 (S 03) ◽

pp. S287-S288 ◽

Cited By ~ 1

Author(s):

Tyler Kenning ◽

Carlos Pinheiro-Neto

Keyword(s):

Cerebrospinal Fluid ◽

Elderly Population ◽

Operative Time ◽

The Elderly ◽

High Flow ◽

Endoscopic Endonasal ◽

Surgical Interventions ◽

Perioperative Morbidity ◽

Increased Risk ◽

Cerebrospinal Fluid Leaks

AbstractExtended endoscopic endonasal procedures are not unique among surgical interventions in carrying increased risk in the elderly population. There are, however, components of the procedure, namely high-flow cerebrospinal fluid leaks, that do result in the potential for increased perioperative morbidity for these patients. We present the case of a 77-year-old male with a large invasive pituitary macroadenoma resected through a transplanum-transtuberculum-transsellar endonasal approach. A gross total resection was obtained with resolution of the patient's preoperative ophthalmologic deficits. One month postoperatively, the patient developed progressive lethargy and cranial imaging demonstrated a left convexity subacute subdural hematoma. This was evacuated through a twist drill craniostomy. Despite measures to limit the operative time of the initial endonasal procedure as well as the absence of a postoperative cerebrospinal fluid fistula, the patient still developed this complication. Along with more typical potential causes of postoperative decline following extended endonasal procedures, problems from high-flow intraoperative cerebrospinal fluid leaks alone can result in morbidity in the elderly population. This should be acknowledged preoperatively and a high suspicion should exist for the presence of intracranial hemorrhage in these patients with any postoperative deficits. Additional intraoperative measures can be utilized to minimize such risks.The link to the video can be found at: https://youtu.be/EkLmt2T8_UE.

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Use of Dental Bisphenol A-Glycidyl Methacrylate Composite to Repair Refractory Cerebrospinal Fluid Leaks Associated With Large-Scale Anterior Skull Base Defects

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000007568 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Djientcheu Vincent de Paul ◽

Casimir Fankem ◽

Dia R. Halalmeh ◽

Ewo Clement ◽

Aubin Sandio ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Bisphenol A ◽

Skull Base ◽

Glycidyl Methacrylate ◽

Large Scale ◽

Anterior Skull Base ◽

Cerebrospinal Fluid Leaks ◽

Skull Base Defects

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