Compare the Outcome of Endoscopic Endonasal versus Transcranial Approach for Cerebrospinal Fluid Leak Repair

2021 ◽  
Vol 15 (8) ◽  
pp. 2224-2227
Author(s):  
Mohammad Mushtaq ◽  
Haider Ali ◽  
Naeem Ul Haq ◽  
Muhammad Anwar Ullah ◽  
Anwar Shah ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Recurrence Rate ◽  
Cerebrospinal Fluid Leak ◽  
Csf Leak ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Group I ◽  
Transcranial Approach ◽  
Group Ii ◽  
Fluid Leak

Objective: The aim of this study is to compare the outcome of endoscopic endonasal verus transcranial approach for cerebrospinal fluid leak repair. Study Design: Comparative study Place and Duration: Conducted at department of Neurosurgery, Mardan Medical Complex/ Bacha Khan Medical College, Mardan during the period from 1st January 2020 to 31st December 2021. Methods: Total eighty patients of both genders were presented in this study. Patients were aged between 20-65 years. Patients’ detailed demographics age, sex and body mass were recorded after taking written consent. Patients had CSF leaks and the history of CSF leak was presented. Patients were equally divided into two groups, I and II. Group I received endonasal technique and group II received transcranial approach. All the patients underwent MRI and CT scan. Complete follow up among both groups were taken in the duration of 8 months for the assessment of efficacy. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients in group I was 33.08±14.90 years with mean BMI28.4±3.12 kg/m2 and in group II mean age was 31.66±4.84 years with mean BMI 27.45±1108 kg/m2. Total 50 (62.5%) patients were males (25 in each group) and 30 (37.5%) patients were females (15 in each group). In group I recurrence rate was found in 3 (7.5%) cases and in group II recurrence rate was 6 (15%). 3 (7.5%) patients in group II developed infection but no infection rate was found in the endoscopic endonasal group. Satisfaction among patients in the endonasal group was greater than that of the transcranial group. Overall efficacy rate among both groups was 71 (88.8%). Conclusion: We concluded in this study that for repair of cerebrospinal fluid leak endoscopic endonasal approach was effective and safe method as compared to transcranial approach. Minimum rate of recurrence and high rate of recovery was fund in endonasal approach. Keywords: CSF, Endoscopic endonasal, Transcranial approach, Complications, Recurrence

scholarly journals Concerns of cerebrospinal fluid leak in aggressive expanded endonasal endoscopic approach for craniopharyngiomas

2020 ◽  
Vol 10 (4) ◽  
pp. 154-156
Author(s):  
Marlon Ortiz Machín ◽  
Omar López Arbolay
Keyword(s):  
Cerebrospinal Fluid ◽  
Third Ventricle ◽  
Cerebrospinal Fluid Leak ◽  
Endoscopic Approach ◽  
Csf Leak ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Nasoseptal Flap ◽  
Endoscopic Endonasal ◽  
Fluid Leak

Cerebrospinal fluid leak represents a frequent complication in Craniopharyngioma´s Endoscopic Endonasal Approach. A descriptive observational investigation was performed in 50 adult patients operated of Craniopharyngiomas by aggressive Expanded Endonasal Endoscopic Approach (EEEA) in “Hermanos Ameijeiras” Hospital since 2010 to 2019 using nasoseptal flap. The 14% of all patients develop CSF leak and 85,7 % of these cases had a great communication into third ventricle creating a cisternoventricular space. Was identified relation with tumor size, hypothalamic invasion and adhesion strength of tumour. Surgical cavity suffered hydrostatic and hydrodynamic pression than lead to CSF leak independent of multilayer reparation.

The endoscopic endonasal approach for cerebrospinal fluid leak repair in the elderly

2015 ◽  
Vol 132 ◽  
pp. 21-25 ◽  
Author(s):  
Enzo Emanuelli ◽  
Laura Milanese ◽  
Marta Rossetto ◽  
Diego Cazzador ◽  
Elena d’Avella ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Leak ◽  
The Elderly ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Fluid Leak

scholarly journals Iatrogenic cerebrospinal fluid leak after repeated nasal swab tests for COVID-19: illustrative case

2021 ◽  
Vol 2 (17) ◽  
Author(s):  
Johnson Ku ◽  
Chieh-Yi Chen ◽  
Jason Ku ◽  
Hsuan-Kan Chang ◽  
Jau-Ching Wu ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Cavity ◽  
Nasal Swab ◽  
Cerebrospinal Fluid Leak ◽  
Cribriform Plate ◽  
Csf Leak ◽  
Illustrative Case ◽  
Endoscopic Endonasal ◽  
Csf Rhinorrhea ◽  
Csf Leakage

BACKGROUND Nasal swab tests are one of the most essential tools for screening coronavirus disease 2019 (COVID-19). The authors report a rare case of iatrogenic cerebrospinal fluid (CSF) leak from the anterior skull base after repeated nasal swab tests for COVID-19, which was treated with endoscopic endonasal repair. OBSERVATIONS A 41-year-old man presented with clear continuous rhinorrhea through his left nostril for 5 days after repeated nasal swabbing for COVID-19. There were no obvious risk factors for spontaneous CSF leak. Computed tomography cisternography showed contrast accumulation in the left olfactory fossa and along the left nasal cavity. Such findings aligned with a preliminary diagnosis of CSF leakage through the left cribriform plate. Magnetic resonance imaging confirmed the presence of a CSF fistula between his left cribriform plate and superior nasal concha. The patient underwent endoscopic endonasal repair. CSF rhinorrhea ceased after the surgery, and no recurrence was noted during the 12-week postoperative follow-up period. LESSONS Although rare, iatrogenic CSF leakage can be a serious complication following COVID-19 nasal swab tests, especially when infection may cause significant neurological sequelae. Healthcare providers should become familiar with nasal cavity anatomy and be well trained in performing nasal swab tests.

Endoscopic Endonasal Approaches to the Clivus with No Violation of the Nasopharynx: Surgical Anatomy and Clinical Illustration

2021 ◽  
Author(s):  
Carlos D. Pinheiro-Neto ◽  
Laura Salgado-Lopez ◽  
Luciano C.P.C. Leonel ◽  
Serdar O. Aydin ◽  
Maria Peris-Celda
Keyword(s):  
Posterior Fossa ◽  
Cerebrospinal Fluid Leak ◽  
Craniovertebral Junction ◽  
Foramen Magnum ◽  
Surgical Anatomy ◽  
Csf Leak ◽  
Surgical Approaches ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal

Abstract Background Despite the use of vascularized intranasal flaps, endoscopic endonasal posterior fossa defects remain surgically challenging with high rates of postoperative cerebrospinal fluid leak. Objective The aim of the study is to describe a novel surgical technique that allows complete drilling of the clivus and exposure of the craniovertebral junction with preservation of the nasopharynx. Methods Two formalin-fixed latex-injected anatomical specimens were used to confirm feasibility of the technique. Two surgical approaches were used: sole endoscopic endonasal approach and transnasion approach. The sole endonasal approach was used in a patient with a petroclival meningioma. Results In both anatomical dissections, the inferior clivectomy with exposure of the foramen magnum was achieved with a sole endoscopic endonasal approach. The addition of the transnasion approach helped to complete drilling of the inferior border of the foramen magnum and exposure of the arch of C1. Conclusion This study shows the anatomical feasibility of total clivectomy and exposure of the craniovertebral junction with preservation of the nasopharynx. A more favorable anatomical posterior fossa defect for the reconstruction is achieved with this technique. Further clinical studies are needed to assess if this change would impact the postoperative CSF leak rate.

Sternberg's Canal and Defect: Is the Lateral Craniopharyngeal Canal a Source of Spontaneous Cerebrospinal Fluid Leak? Anatomic and Radiological Analysis in Pediatric and Adult Populations

2021 ◽  
Author(s):  
Adedamola Adepoju ◽  
Lucas P Carlstrom ◽  
Christopher S Graffeo ◽  
Avital Perry ◽  
Carlos Diogenes Pinheiro-Neto ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Adult Population ◽  
Cerebrospinal Fluid Leak ◽  
Csf Leak ◽  
Superior Orbital Fissure ◽  
Old Patients ◽  
Visual Illustration ◽  
Craniopharyngeal Canal ◽  
High Incidence ◽  
Fluid Leak

Abstract BACKGROUND The lateral craniopharyngeal or Sternberg's canal (SC) originates from superior orbital fissure (SOF) and traverses the sphenoid body into the nasopharynx. A remnant of the canal, Sternberg's defect (SD), has been debated as a source of cerebrospinal fluid (CSF) leak. The canal was described in 1888, and there is limited accurate visual illustration in the literature. OBJECTIVE To provide a detailed anatomic and radiological illustration of the canal in pediatric and adult population including the mechanism undermining the incidence of the canal, and the possibility of the canal as a source of CSF leak. METHODS A total of 195 high-resolution computed tomographies (CT) of patients (50 3-yr-old, 20 5-yr-old, and 125 adults) and 43 dry adult skulls (86 sides) were analyzed for a canal matching the description of the SC. RESULTS A SC was identified in 86% of the 3-yr-old and 40% of 5-yr–old patients. The diameter and length were 2.12 mm and 12 mm, respectively. The incidence of the canal decreased with age as sinus pneumatization extended into the sphenoid sinus. Only 0.8% of the adult skull on CT had the canal. The canal was not present on the dry adult skulls examination, but SD was found in 4.65%. CONCLUSION SC exists with high incidence in the pediatric group. Sinus pneumatization obliterates the canal in the adult population, leaving a defect in 4.65% of cases, which given the location and related anatomic structures, is unlikely to be a source of CSF leak.

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