scholarly journals Simultaneous repair of the skull base and the frontal lobe defect using CAD-CAM technology

2021 ◽  
Author(s):  
OV Ivanov
Keyword(s):  
Traumatic Brain Injury ◽  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Postoperative Period ◽  
Revision Surgery ◽  
Frontal Bone ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Cad Cam ◽  
Cosmetic Effect ◽  
Car Accident

Many patients with traumatic brain injury develop complications in the postoperative period. The article describes a case of revision surgery in a female patient with cerebrospinal fluid rhinorrhea following a severe car accident. During one surgery, the skull base and the frontal bone defect were repaired and a lumboperitoneal shunt was placed. The skull base was repaired using an autologous musculoaponeurotic graft. For a better cosmetic effect, the implant was designed using CADCAM technologies. The patient had a relapse of the leak in the postoperative period, which required revision surgery (multilayer reconstruction using a fibrin-thrombin sponge). The patient was followed up for 2 years, with no relapse. The desired clinical and cosmetic effects were successfully achieved.

Detection of Cerebrospinal Fluid Leaks Using the Endoscopic Fluorescein Test in the Post-Operative Period Following Pituitary and Ventral Skull Base Surgery

2021 ◽  
Author(s):  
Peter A. Benedict ◽  
Joseph R. Connors ◽  
Micah R. Timen ◽  
Nupur Bhatt ◽  
Richard Lebowitz ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Postoperative Period ◽  
Skull Base Surgery ◽  
Tertiary Care ◽  
Csf Leak ◽  
Csf Rhinorrhea ◽  
Predictive Values ◽  
Ventral Skull Base ◽  
Csf Leaks

Objective: Diagnosis of cerebrospinal fluid (CSF) leaks is sometimes challenging in the postoperative period following pituitary and ventral skull base surgery. Intrathecal fluorescein (ITF) may be useful in this setting. Design: Retrospective chart review Setting: Tertiary care center Methods and Participants: All patients who underwent pituitary and ventral skull base surgery performed by a single rhinologist between January 2017–March 2020 were included. There were 103 patients identified. Eighteen patients received 20 ITF injections due to clinical suspicion for CSF leak during the postoperative period without florid CSF rhinorrhea on clinical exam. Computed tomography scans with new or increasing intracranial air and intra-operative findings were used to confirm CSF leaks. Clinical courses were reviewed for at least 6 months after initial concern for leak as the final determinate of CSF leak. Main Outcome Measures: Specificity and safety of ITF Results: Eleven (61%) ITF patients were female and 7 (39%) were male. Average patient age was 52.50±11.89. There were 6 patients with confirmed postoperative CSF leaks, 3 of whom had evaluations with ITF. ITF use resulted in 2 true positives, 1 false negative, 17 true negatives and 0 false positives. ITF sensitivity was 67%, specificity was 100%, and positive and negative predictive values were 100% and 94.4%, respectively. There were no adverse effects from ITF use. Conclusions: Existing modalities for detecting postoperative CSF leaks suffer from suboptimal sensitivity and specificity, delayed result reporting, or limited availability. Intrathecal fluorescein represents a specific and safe test with potential utility in the postoperative setting.

Managing Cerebrospinal Fluid Rhinorrhea after Lateral Skull Base Surgery via Endoscopic Endonasal Eustachian Tube Closure

2015 ◽  
Vol 29 (3) ◽  
pp. 207-210 ◽  
Author(s):  
Lori A. Lemonnier ◽  
Belachew Tessema ◽  
Arjuna B. Kuperan ◽  
Deya N. Jourdy ◽  
Fred F. Telischi ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Eustachian Tube ◽  
Skull Base Surgery ◽  
Endoscopic Endonasal ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Lateral Skull Base ◽  
Tube Closure

scholarly journals Purely Endoscopic Repair of Traumatic Cerebrospinal Fluid Rhinorrhea From the Anterior Skull Base

2011 ◽  
Vol 51 (3) ◽  
pp. 222-225 ◽  
Author(s):  
Mika KOMATSU ◽  
Fuminari KOMATSU ◽  
Luigi M. CAVALLO ◽  
Domenico SOLARI ◽  
Vita STAGNO ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Anterior Skull Base ◽  
Endoscopic Repair ◽  
Cerebrospinal Fluid Rhinorrhea

Endoscopic CSF rhinorrhea closure: Our experience in 267 cases

2005 ◽  
Vol 132 (2) ◽  
pp. 208-212 ◽  
Author(s):  
Milind V. Kirtane ◽  
K. Gautham ◽  
Shraddha R. Upadhyaya
Keyword(s):  
Cerebrospinal Fluid ◽  
Revision Surgery ◽  
Fascia Lata ◽  
Sinus Surgery ◽  
Minimum Period ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Endoscopic Closure ◽  
Transnasal Endoscopic Approach ◽  
Beta 2

OBJECTIVES: The advances in endoscopic sinus surgery have made it the procedure of choice for treatment of cerebrospinal fluid rhinorrhea (CSFR). To analyze the efficacy of endoscopic closure of CSFR was the objective of the present study. METHODS: We treated 267 patients with CSFR endo-scopically. Diagnosis was achieved with the help of CT with or without cisternography, MRI, beta-2 transferrin levels. Fascia lata and fat were used to plug the defects. The patients were followed up for a minimum period of 6 months. RESULTS: CSFR was successfully plugged in 258 patients. Nine patients required revision surgery. Six could be plugged successfully endoscopically and 2 patients by a neurosurgical approach. CONCLUSIONS: In our experience with 267 patients of endoscopically treated CSFR, the results of achieving the closure was 96.63% in the first instance and 98.88% after revision surgery. SIGNIFICANCE: The transnasal endoscopic approach has excellent results in the treatment of CSFR. We recommend it as the optimum surgical approach for both primary and revisional surgical management of CSFR.

scholarly journals Pseudo-cerebrospinal Fluid Rhinorrhea After Skull Base Surgery —Case Report—

1998 ◽  
Vol 38 (6) ◽  
pp. 371-373
Author(s):  
Hideo HAMADA ◽  
Shunro ENDO ◽  
Takuya AKAI ◽  
Masayoshi OHI ◽  
Masanori KURIMOTO ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Cerebrospinal Fluid Rhinorrhea
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