Delayed Cerebrospinal Fluid Leak following Septoplasty

2009 ◽  
Vol 118 (9) ◽  
pp. 636-638 ◽  
Author(s):  
Alok Thakar ◽  
Priti Lal ◽  
Rohit Verma
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Clinical Syndrome ◽  
Cribriform Plate ◽  
Endoscopic Repair ◽  
Ethmoid Bone ◽  
Septal Surgery ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

We report on the clinical syndrome of delayed cerebrospinal fluid leak following septoplasty. We describe 2 such cases that we treated, and 1 other case described in the literature. A review of these 3 cases indicates a characteristic clinical and radiologic presentation and a consistent site of cerebrospinal fluid leak. All cases presented with cerebrospinal fluid leak 12 to 22 weeks after septoplasty and had slit-shaped dehiscences at the horizontal lamella of the cribriform plate. Endoscopic repair was successful in all. Delayed cerebrospinal fluid leaks may occur as a consequence of septal surgery. It is probable that uncontrolled twisting and rocking manipulations of the perpendicular plate of the ethmoid bone are transmitted to, and injure, the cribriform plate.

Successful Endoscopic Repair of Persistent Cerebrospinal Fluid Leak Following Attempted Transcranial Repair

2013 ◽  
Vol 74 (S 01) ◽  
pp. e107-e110 ◽  
Author(s):  
Alan Siu ◽  
Rishi Vashishta ◽  
Joseph Goodman ◽  
Fabio Roberti ◽  
Ameet Singh
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Endoscopic Repair ◽  
Fluid Leak

scholarly journals DuraSeal™ in Endoscopic Repair of Cerebrospinal Fluid Leak

2012 ◽  
Vol 147 (2_suppl) ◽  
pp. P108-P109
Author(s):  
Joshua C. Yelverton ◽  
Priyam K. Vyas ◽  
Laurence J. DiNardo
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Endoscopic Repair ◽  
Fluid Leak

“Gasket-seal” Watertight Closure in Minimal-access Endoscopic Cranial Base Surgery

2008 ◽  
Vol 62 (suppl_5) ◽  
pp. ONS342-ONS343 ◽  
Author(s):  
Lewis Z. Leng ◽  
Seth Brown ◽  
Vijay K. Anand ◽  
Theodore H. Schwartz
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
Cranial Base ◽  
Minimal Access ◽  
Anterior Cranial Base ◽  
Tissue Sealant ◽  
Cerebrospinal Fluid Leaks ◽  
Cranial Base Surgery ◽  
Watertight Closure ◽  
Fluid Leak

Abstract Objective: Transnasal endoscopic cranial base surgery is a novel minimal-access method for reaching the midline cranial base. Postoperative cerebrospinal fluid leak remains a persistent challenge. A new method for watertight closure of the anterior cranial base is presented. Methods: To achieve watertight closure of the anterior cranial base, autologous fascia lata was used to create a “gasket seal” around a bone buttress, followed by application of a tissue sealant such as DuraSeal (Confluent Surgical, Inc., Waltham, MA). The gasket-seal closure was used to seal the anterior cranial base in a series of 10 patients with intradural surgery for suprasellar craniopharyngiomas (n = 5), planum meningiomas (n = 3), clival chordoma (n = 1), and recurrent iatrogenic cerebrospinal fluid leak (n = 1). Lumbar drains were placed intraoperatively in five patients and remained in place for 3 days postoperatively. Results: After a mean follow-up period of 12 months, there were no cerebrospinal fluid leaks. Conclusion: The gasket-seal closure is an effective method for achieving watertight closure of the anterior cranial base after endoscopic intradural surgery.

Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks

2014 ◽  
Vol 128 (7) ◽  
pp. 626-629 ◽  
Author(s):  
J Rimmer ◽  
C Belk ◽  
V J Lund ◽  
A Swift ◽  
P White
Keyword(s):  
Cerebrospinal Fluid ◽  
Streptococcus Pneumoniae ◽  
Antibiotic Prophylaxis ◽  
Skull Base ◽  
Cerebrospinal Fluid Leak ◽  
Prophylactic Antibiotics ◽  
Anterior Skull Base ◽  
Web Based ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

AbstractObjective:There are no UK guidelines for the use of antibiotics and/or immunisations in patients with an active anterior skull base cerebrospinal fluid leak. This study aimed to define current UK practice in this area and inform appropriate guidelines for ENT surgeons.Method:A web-based survey of all members of the British Rhinological Society was carried out and the literature in this area was reviewed.Results:Of those who responded to the survey, 14 per cent routinely give prophylactic antibiotics to patients with cerebrospinal fluid leaks, and 34.9 per cent recommend immunisation against at least one organism, most commonly Streptococcus pneumoniae (86.7 per cent).Conclusion:There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.

Endoscopic modified Lothrop procedure for repair of lateral frontal sinus cerebrospinal fluid leak

2008 ◽  
Vol 123 (1) ◽  
pp. 145-147 ◽  
Author(s):  
J K Anverali ◽  
A A Hassaan ◽  
H A Saleh
Keyword(s):  
Cerebrospinal Fluid ◽  
Frontal Sinus ◽  
World Literature ◽  
Cerebrospinal Fluid Leak ◽  
Lumbar Drain ◽  
Alternative Approach ◽  
Cerebrospinal Fluid Leaks ◽  
Fluid Leak

AbstractObjective:To describe a previously unreported case of repair of a lateral frontal sinus cerebrospinal fluid leak, using the endoscopic modified Lothrop procedure.Method:Case report of new technique, with reference to the world literature.Results:An effective endoscopic, transnasal repair of a lateral frontal sinus cerebrospinal fluid leak was achieved in a 60-year-old man. The defect was closed with fat, fascia lata and free mucosal grafts. The left nasal cavity was packed and a lumbar drain left in situ post-operatively. The drain and packs were removed one week later and the patient discharged with no complications, and no recurrence at 12 months' follow up.Conclusion:Such cerebrospinal fluid leaks have traditionally been repaired using an external approach with osteoplastic flaps and obliteration of the sinus. We highlight the endoscopic modified Lothrop technique as an effective alternative approach to repair of cerebrospinal fluid leaks in poorly accessible areas of the frontal sinus.

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