scholarly journals Resolution of Chronic Aspiration Pneumonitis following Endoscopic Endonasal Repair of Spontaneous Cerebrospinal Fluid Fistula of the Skull Base: A Case Series

2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Author(s):  
Maya Or ◽  
Samridhi Amba ◽  
Justin Seltzer ◽  
Roozera Khan ◽  
Bozena Wrobel ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Case Series ◽  
Aspiration Pneumonitis ◽  
Cerebrospinal Fluid Fistula ◽  
Endoscopic Endonasal ◽  
Fluid Fistula

Extradural cartilage inlay graft in cerebrospinal fluid fistula repair

2010 ◽  
Vol 124 (12) ◽  
pp. 1294-1297 ◽  
Author(s):  
P Thulasi Das ◽  
D Balasubramanian
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Success Rate ◽  
Bony Defect ◽  
Cerebrospinal Fluid Fistula ◽  
Fistula Repair ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Skull Base Defects ◽  
Fluid Fistula

AbstractObjective:To present our experience in managing cerebrospinal fluid rhinorrhoea using the cartilage inlay (underlay) technique to repair skull base defects larger than 4 mm.Study design:Retrospective study involving patients presenting with cerebrospinal fluid rhinorrhoea between 1994 and 2008.Setting:Patients were treated in a tertiary referral centre for nose and sinus diseases. Patients' medical records were reviewed and analysed.Results:A total of 62 patients were operated upon using a cartilage inlay technique to repair bony skull base defects ranging in size from 4 to 20 mm (widest diameter). Of these 62 patients, 16 constituted revisions of earlier procedures undertaken elsewhere. The success rate of the technique was 100 per cent. Patient follow up ranged from six months to 16 years, with a median follow up of 15 months. Three patients had minor post-operative sinus infections; no serious complications were encountered.Conclusion:Extradural cartilage inlay appears to be an effective technique in the management of cerebrospinal fluid rhinorrhoea, especially for large defects and revision procedures. To our knowledge, the described patients represent the largest reported series of cerebrospinal fluid rhinorrhoea cases managed using the cartilage inlay technique. We believe that the crucial factors in our high success rate for cerebrospinal fluid fistula repair are: precise identification of the bony defect; meticulous preparation of the graft bed; careful elevation of the dura; judicious use of just enough graft tissue; and adequate graft support.

The use of platelet gel for repair of a cerebrospinal fluid fistula of the skull base (a case report and literature review)

2018 ◽  
Vol 82 (1) ◽  
pp. 86
Author(s):  
O. I. Sharipov ◽  
M. A. Kutin ◽  
A. V. Bayuklin ◽  
A. A. Imaev ◽  
A. A. Abdilatipov ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Literature Review ◽  
Skull Base ◽  
Cerebrospinal Fluid Fistula ◽  
Platelet Gel ◽  
Fluid Fistula

scholarly journals The efficacy of an endoscopic endonasal approach in the repair of cerebrospinal fluid fistula: a clinical analysis

2019 ◽  
Vol 5 (4) ◽  
pp. 90
Author(s):  
Fulya Ozer ◽  
Can Alper Cagici ◽  
Cem Ozer ◽  
Cuneyt Yilmazer
Keyword(s):  
Cerebrospinal Fluid ◽  
Endoscopic Approach ◽  
Graft Material ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Cerebrospinal Fluid Fistula ◽  
Endoscopic Repair ◽  
Endoscopic Endonasal ◽  
Csf Leakage ◽  
Fluid Fistula

<p class="abstract"><strong>Background:</strong> Cerebrospinal fluid (CSF) fistula is an abnormal CSF leakage due to bone and/or dural defect of the skull base and usually operated with endonasal endoscopic approach. The aim of this study was to determine the efficacy of an endonasal endoscopic approach in the repair of CSF leakage and to find the reasons of the recurrence of endoscopic procedure.</p><p class="abstract"><strong>Methods:</strong> The medical records of 24 patients that presented with the diagnosis of cerebrospinal fluid fistula and who had undergone endonasal endoscopic repair surgery were reviewed retrospectively.  </p><p class="abstract"><strong>Results:</strong> 13 patients (54.2%) were found to have spontaneous CSF fistulas without any history of trauma, while 11 patients (45.8%) had posttraumatic CSF fistulas. The mean body mass index (BMI) of patients was 31. 3 kg/m² (20.1-49.6). Nasal septal cartilage was used as a graft material in 19 patients (79%) while only fascia was used in 5 patients (21%). The evaluation of long-term results revealed recurrence in 4 patients (16.6%). Two of these patients required a second surgical repair.</p><p class="abstract"><strong>Conclusions:</strong> An endoscopic endonasal approach is a safe method with less morbidity and a reliable outcome in the repair of CSF fistulas. The most important causative factors in the recurrence of endoscopic repair of CSF leak might be to have high BMI and not to use multilayered graft material for closure of fistula.</p><p class="abstract"> </p>

Novel Equine Collagen-Only Dural Substitute

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONSE273-ONSE274 ◽  
Author(s):  
Francesco Biroli ◽  
Felice Esposito ◽  
Mario Fusco ◽  
Giorgio G. Bani ◽  
Antonio Signorelli ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Bone Flap ◽  
Neurological Deficits ◽  
Neurosurgical Procedures ◽  
Cerebrospinal Fluid Fistula ◽  
Endoscopic Endonasal ◽  
Systemic Complications ◽  
Dural Substitute ◽  
Dural Closure ◽  
Fluid Fistula

Abstract Objective: A watertight and meticulous dural closure is an essential step after intradural neurosurgical procedures. When such a task cannot be performed, dural replacement materials and other adjunctive measures can provide an effective barrier between the subarachnoid compartment and the extradural space. Methods: We present our experience with a novel collagen-derived dural substitute in a series of 114 patients undergoing a variety of neurosurgical procedures. The patients were clinically or neuroradiologically observed, for immediate and delayed local or systemic complications related to the implant. In three patients who underwent reoperation after decompressive duraplasty and craniectomy for bone flap repositioning, we performed biopsy of the dural implant for histopathological studies. Results: None of the patients experienced local or systemic complications or toxicity related to the dural patch. None of the patients experienced a postoperative cerebrospinal fluid fistula, except one patient who underwent an endoscopic endonasal transsphenoidal marsupialization of a large intrasuprasellar arachnoid cyst; the fistula required reoperation for cerebrospinal fluid fistula repair and intravenous antibiotic therapy for bacterial meningitis. Postoperative magnetic resonance imaging scans showed signs of severe inflammatory response in only one patient who did not present any postoperative clinical symptom or neurological deficits. Three patients underwent reoperation for bone flap repositioning after decompressive craniectomy; in all patients, the dural substitute appeared to have promoted satisfactory dural regeneration, as confirmed by the histological studies. Furthermore, in such patients, no or minimal adherence with the other tissues and the brain cortex was observed. Conclusion: This study demonstrates that the new collagen-only biomatrix is a safe and effective dural substitute for routine neurosurgical procedures. The absence of local and systemic toxicity or complications and the scarce promotion of adherences and inflammation make this material appealing for its use as a dural substitute, even in cases in which the necessity of reoperation is foreseen.

Skull base cerebrospinal fluid fistula

2012 ◽  
Vol 32 (6) ◽  
pp. Introduction ◽  
Author(s):  
John Diaz Day ◽  
Anil Nanda
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Cerebrospinal Fluid Fistula ◽  
Fluid Fistula

The advantages of using auto-fat tissue in the reconstruction of defects of the skull base in patients with CSF leak

2018 ◽  
pp. 18-23
Author(s):  
Dmitry Zabolotny ◽  
Diana Zabolotnaya ◽  
Eldar Ismagilov
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Skull Base ◽  
Csf Leak ◽  
Fat Tissue ◽  
Cerebrospinal Fluid Fistula ◽  
Overlay Technique ◽  
Skull Base Defect ◽  
Group 2 ◽  
Fluid Fistula

Relevance: At present, the method of repair of the cerebrospinal fluid fistula using mucous flaps according to the “overlay” technique is widely used in the reconstruction of the skull base and is generally accepted. We have developed an original method for reconstructing defects of the skull base in the presence of a cerebrospinal fluid fistula, using an auto-fat tissue and placing it in two layers. Objectives: To conduct a comparative assessment of methods for the reconstruction of the skull base defect in patients with CSF leak using endoscopic endonasal approach. Materials and methods: Under our supervision there were 46 patients with CSF leak. Depending on the technique of cerebrospinal fluid fistula repair, all patients were divided into 2 groups. The first group of 20 patients consisted of patients who underwent surgery with auto-fat tissue according to our proposed technique. The second group - 26 patients were patients who underwent repair of the skull base defect using the standard overlay technique - a mucous flap on the feeding vascular pedicle. The criterion for evaluating the effectiveness of surgical treatment was patient complaints and data from objective research methods (endoscopic examination of the nasal cavity). Results: After 3 months after surgical treatment, a patient of group 1 had a recurrence of liquorrhea, patients of group 2 after 3 months had a recurrence of liquorrhea in 3 patients, after 6 months in 2 patients of group 2 there was a recurrence of liquorrhea. Findings: When the size of the bone defect of the base of the skull is up to 0.6 cm, the original technique proposed by us for plastics of the cerebrospinal fluid fistula with an auto-fat tissue in two layers provides a tight closure of the bone defect and the defect of the dura mater. When using this method of plastics, the risk of the development of a recurrence of CSF leak is significantly reduced in comparison with the plastics of the cerebrospinal fluid fistula with the use of overlay grafts.

Skull base cerebrospinal fluid fistula: a novel detection method based on two-dimensional electrophoresis

Head & Neck ◽  
2004 ◽  
Vol 26 (5) ◽  
pp. 464-469 ◽  
Author(s):  
Alma Ricchetti ◽  
Pierre R. Burkhard ◽  
Neftali Rodrigo ◽  
Zdravko Gamulin ◽  
Mélanie Côte ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Detection Method ◽  
Two Dimensional ◽  
Cerebrospinal Fluid Fistula ◽  
Two Dimensional Electrophoresis ◽  
Dimensional Electrophoresis ◽  
Fluid Fistula
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