Management of cerebrospinal fluid leak in the lateral recess of the sphenoid sinus with transpterygoid approach: A case report

Background Lesions affecting sphenoid sinus lateral recess (SSLR) are difficult to visualize and manipulate through the transnasal routes, especially when the sinus is highly pneumatized. External approaches to this area involve extensive surgery and are associated with significant morbidity. The aims of this study are to present our experience with the endoscopic transpterygoid approach as a method for approaching lesions of the SSLR and to evaluate the outcomes of this procedure.Methods Clinical charts of patients who had lesions in the SSLR and who were treated at our institution from September 1998 to June 2018 were retrospectively reviewed. All these patients were managed by the endoscopic endonasal transpterygoid approach.Results Thirty-nine patients were identified. No cerebrospinal fluid leak recurrences were observed during follow-up (range: 1–19.7 years; median: 2.3 years). Hypoesthesia (temporary, 1; persistent, 4) in the region innervated by the maxillary branch of the trigeminal nerve was detected in five (12.8%) patients, while symptoms due to the Vidian nerve damage (dry eye, 3; dry nasal mucosa, 1) were present in four (10%) patients.Conclusions Although the endoscopic endonasal transpterygoid approach is an excellent corridor for dealing with lesions of the SSLR, limited rate of neurologic and lacrimal complications was observed. Potential morbidity of the intervention should be discussed during preoperative counselling.

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Cerebrospinal Fluid Leak following Balloon Sinuplasty of Sphenoid Sinus: A Case Report and Review of the Literature

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1633646 ◽

2018 ◽

Vol 79 (S 01) ◽

pp. S1-S188

Author(s):

Amar Miglani ◽

Joseph Hoxworth ◽

Devyani Lal

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Sphenoid Sinus ◽

Cerebrospinal Fluid Leak ◽

Review Of The Literature ◽

Balloon Sinuplasty ◽

Fluid Leak

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Spontaneous cerebrospinal fluid leak of the sphenoid sinus mimicking allergic rhinitis, and managed successfully by a ventriculoperitoneal shunt: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-016-1107-0 ◽

2016 ◽

Vol 10 (1) ◽

Cited By ~ 9

Author(s):

Youssef Darouassi ◽

Mohamed Mliha Touati ◽

Mehdi Chihani ◽

Ali Akhaddar ◽

Haddou Ammar ◽

...

Keyword(s):

Allergic Rhinitis ◽

Cerebrospinal Fluid ◽

Case Report ◽

Ventriculoperitoneal Shunt ◽

Sphenoid Sinus ◽

Cerebrospinal Fluid Leak ◽

Fluid Leak

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Case report: spontaneous intracranial hypotension in association with the presence of a false localizing C1-C2 cerebrospinal fluid leak

Surgical Neurology ◽

10.1016/j.surneu.2007.05.037 ◽

2008 ◽

Vol 70 (5) ◽

pp. 539-543 ◽

Cited By ~ 8

Author(s):

Jonathan T. Morgan ◽

Alexander J. Scumpia ◽

Alan A. Johnson ◽

Steven J. Schneider

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Intracranial Hypotension ◽

Spontaneous Intracranial Hypotension ◽

Cerebrospinal Fluid Leak ◽

Fluid Leak

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Endoscopic endonasal transpterygoid approach for reduction of a lateral recess encephalocele with postoperative cerebrospinal fluid leak

BMJ Case Reports ◽

10.1136/bcr-2020-235877 ◽

2020 ◽

Vol 13 (9) ◽

pp. e235877

Author(s):

Adham M Khalafallah ◽

Omar G Ahmed ◽

Nicholas R Rowan ◽

Debraj Mukherjee

Keyword(s):

Cerebrospinal Fluid ◽

Cerebrospinal Fluid Leak ◽

Endoscopic Endonasal ◽

Lateral Recess ◽

Fluid Leak

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Cranio-cervical junction cerebrospinal fluid leak after microdebrider-assisted adenoidectomy – A rare case report

Acta Otorrinolaringológica Española ◽

10.1016/j.otorri.2017.01.006 ◽

2018 ◽

Vol 69 (1) ◽

pp. 53-55

Author(s):

Karthikeyan Ramasamy ◽

Hemanth Vamanshankar ◽

Sunil Kumar Saxena ◽

Vignesh Karunakaran ◽

Arun Alexander

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Rare Case ◽

Cerebrospinal Fluid Leak ◽

Rare Case Report ◽

Fluid Leak

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Myelomeningocele with Unilateral Right Renal Agenesis: A Case Report

American Journal of Perinatology Reports ◽

10.1055/s-0037-1615818 ◽

2018 ◽

Vol 08 (01) ◽

pp. e1-e3

Author(s):

Hajime Maeda ◽

Hayato Go ◽

Jun Sakuma ◽

Takashi Imamura ◽

Maki Sato ◽

...

Keyword(s):

Renal Failure ◽

Cerebrospinal Fluid ◽

Case Report ◽

Congenital Anomalies ◽

Renal Agenesis ◽

Cerebrospinal Fluid Leak ◽

Surgical Risk ◽

Genitourinary System ◽

Fluid Leak

AbstractCongenital anomalies of the spine may occur with malformations of the central nervous, cardiovascular, gastrointestinal, respiratory, and genitourinary systems. This is a case of myelomeningocele with unilateral right renal agenesis in a newborn. The patient suffered complications of cerebrospinal fluid leak and meningitis, but was successfully treated and discharged on day 86. In this case, unilateral right renal agenesis represented a significant surgical risk because failure of the remaining kidney could result in renal failure. Because congenital anomalies of the spine may be associated with malformations of the genitourinary system, and additional surgeries were necessary in our case following birth, it is very important that the presence of genitourinary malformations be evaluated.

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