csf rhinorrhea surgery recovery

Marton E, Billeci D, Schiesari E, Longatti P. Transnasal endoscopic repair of cerebrospinal fluid fistulas and encephaloceles: Surgical indications and complications. Ryall RG, Peacock MK, Simpson DA. The possible role of these factors or their combinations must be considered when planning adequate therapy for a spontaneous CSF leak. Ann Otol Rhinol Laryngol 2001;110:142-7. Our personal experience also indicates that spontaneous CSF rhinorrhea is not a condition as infrequent as was formerly believed. 6th and 7th Floor, Neuroscience Neurosurg Clin. those of nonsurgical experts and researchers. A common finding in this series was extremely pneumatized sphenoid sinuses that extended to the apex of the temporal pyramid (Figure 1). Cerebrospinal fluid (CSF) rhinorrhea is a common brain condition that is treated with neurosurgery. Marks SC.  MMFatterpekar Management of unexpected cerebrospinal fluid leak during endoscopic sinus surgery. Minim Invasive Neurosurg 2011;54:110-4. Endoscopic repair of CSF rhinorrhea (drainage from the nose) In this procedure, the physician accesses the leak through the patient’s nose, avoiding an external incision. J Neurosurg. 2015 Mar-Apr. Lee TJ, Huang CC, Chuang CC, Huang SF. 2004 Aug. 114(8):1475-81. If you have drainage, your doctor may collect a sample for testing. 2020; : 1, Indian Journal of Anaesthesia.  DBullock  GD Endoscopic repair of cerebrospinal fluid rhinorrhea: learning from our failures.  RNSetzen Lindstrom DR, Toohill RJ, Loehrl TA, Smith TL. In 5 of the 6 patients who had an extremely pneumatized sphenoid sinus, the source of the leak was located in the lateral extension of the sinus. Intervention  Lanny Garth Close, MD is a member of the following medical societies: Alpha Omega Alpha, American Head and Neck Society, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physicians, American Laryngological Association, New York Academy of MedicineDisclosure: Nothing to disclose. Surgical repair of spontaneous cerebrospinal fluid (CSF) leaks: A systematic review. Neurosurgery 2006;58 (4 Suppl 2):ONS-246-56; discussion ONS-256-7. Adams AS, Francis DO, Russell PT. or 817-882-2700, 5323 Harry Hines Blvd. Schick The duration of the condition, ie, the period between first presentation of the CSF leak and admittance to the clinic, was less than 2 months in 2 cases, between 2 and 6 months in 7 cases, and between 6 and 12 months in 4 cases. Consensus statements are issued by a panel of experts and are based on the latest available scientific evidence and clinical experience, constituting the key clinical manuals for diagnosing and treating medical conditions. problem. Gassner HG, Ponikau JU, Sherris DA, Kern EB. Appropriate treatment for raised ICP, in addition to proper repair, should be done to prevent recurrence. Tahir MZ, Khan MB, Bashir MU, Akhtar S, Bari E. Cerebrospinal fluid rhinorrhea: An institutional perspective from Pakistan. However, treatment of CSF fistulas in the lateral part of the sphenoid sinus needs further perfecting. 2020 Feb 28. However, the patient reported improvement (a reduction in the amount of CSF released and an absence of meningitis). 2015 Apr 28. Twenty-one consecutive patients who presented with spontaneous CSF leak and underwent endonasal endoscopic surgery from January 1999 through December 2001. Lobo BC, Baumanis MM, Nelson RF. Ratilal BO, Costa J, Pappamikail L, Sampaio C. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Endoscopic CSF leak repair. High-resolution computed tomography and magnetic resonance cisternography are complementary to each other and are the investigation of choice. Sughrue ME, Aghi MK. Zweig JL, Carrau RL, Celin SE, Schaitkin BM, Pollice PA, Snyderman CH, https://www.asianjns.org/text.asp?2016/11/3/183/145101, American Journal of Otolaryngology. Treatment outcomes of endoscopic repairs of sinonasal cerebrospinal fluid leaks. J Neurosurg. Bell RB, Dierks EJ, Homer L, Potter BE. Spontaneous CSF rhinorrhea has always been considered an infrequent entity that constitutes not more than 3% to 4% of all CSF leaks. Arq Neuropsiquiatr 2004;62:827-31. Eljamel MS, Pidgeon CN, Toland J, et al. Large defects can be repaired when sufficient experience is acquired. In our group extensive pneumatization of the sphenoid sinus was revealed in 6 patients, and a meningocele protruding through a bone defect in the lateral part of the overpneumatized sinus was found in 4 patients. New techniques and technology to repair cerebrospinal fluid rhinorrhea. J Laryngol Otol 2005;119:866-74. Landeiro JA, Lázaro B, Melo MH. Ann Saudi Med 2004;24:453-8. If a leak fails medical management then a procedure may be needed to repair the defect leading to the brain. Shi JB, Chen FH, Fu QL, Xu R, Wen WP, Hou WJ. to download free article PDFs, New Patient Appointment An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS), Endoscopic management of cerebrospinal fluid rhinorrhea Reconstruction of dural defects of the endonasal skull base. Kreatsoulas DC, Shah VS, Otto BA, Carrau RL, Prevedello DM, Hardesty DA. Glucose concentration in the nasal discharge was higher than 30 mg/dL (1.7 mmol/L) in all patients. James Stankiewicz, MD Professor, Chair, Program Director, Department of Otolaryngology-Head and Neck Surgery, Loyola University Chicago School of Medicine Bol Asoc MedPR 2009;101:29-33. Bibas AG, Skia B, Hickey SA. Your health can’t wait. for: Medscape. Kim S, Park CH, Park K. Cerebrospinal fluid rhinorrhea caused by a congenital defect of stapesmimickingotorrhea: Radionuclide cisternographic findings. Southwestern Medical Center provides rapid diagnosis of cerebrospinal fluid Endoscopic transnasal intradural repair of anterior skull base cerebrospinal fluid fistulae. The operation began with a careful endoscopic examination of the nasal cavity. There has been a paradigm shift over the last 30 years while choosing the best approach given the advancements made in endoscopic techniques. Spontaneous CSF rhinorrhea: prevalence of multiple simultaneous skull base defects. Obliteration of the cavity of the ethmoidal cells and medial displacement of the middle turbinate were performed in a way that did not obstruct the frontal sinus ostium. Diseases & Conditions, 2002 CSF rhinorrhea is a condition where cerebrospinal fluid (CSF) leaks through the nose. 30(4):399-405. In our series, 20 patients were treated successfully and the only recurrence was a case where the fistula was in this particular location. Professor Christos Georgalas, Workshop organizer and head of the consensus committee, noted, “The new consensus statements highlight the significance of a multidisciplinary approach in managing idiopathic CSF rhinorrhea, underpinning the need to check patients for intracranial hypertension. [Medline]. Terms of Use| Head trauma is the most common cause of CSF leak and most trauma-related CSF leaks resolve without surgical intervention. If leakage persists, other treatment options may need to be considered. Chan DT, Poon WS, IP CP, Chiu PW, Goh KY. How useful is glucose detection in diagnosing cerebrospinal fluid leak? The duration of undiagnosed CSF rhinorrhea ranged from 15 years to 4 days 5, 11, 13with the exception of cases in which the CSF leak was identified at the time of occurrence and repaired intraoperatively (e.g., endoscopic sinus surgery or tumor ablative surgery). Platt MP, Parnes SM. A case report and literature review. Composite mucochondral flap for repair of cerebrospinal fluid leaks. As there is no universal technique, specific surgical options and choice of plastic materials depend on the fistula's size and location. The Bumm K, Heupel J, Bozzato A, Iro H, Hornung J. Localization and infliction pattern of iatrogenic skull base defects following endoscopic sinus surgery at a teaching hospital. MRI cisternography, and the localization of CSF fistulae. It could be due to trauma, raised intracranial pressure (ICP), tumors, erosive diseases, and congenital skull defects. Follow-up varied from 9 to 42 months. Endonasal Endoscopic Repair of Spontaneous Cerebrospinal Fluid Leaks. If surgery is necessary, UPMC surgeons will use the Endoscopic Endonasal Approach (EEA) to repair CSF leaks of the skull base. J Neurosurg. Otolaryngol Pol 2003;57:75-9. Curr Opin Otolaryngol Head Neck Surg 2007;15:35-9. Please confirm that you would like to log out of Medscape. (Defect measured approximately 7mm.). Septal cartilage was used exclusively for closure of large bone defects in the roofs of the ethmoidal sinuses. We’re one of the world’s top academic medical centers, with a unique legacy of innovation in patient care and scientific discovery. Search for opportunities to participate in a neurology research study. Laryngoscope 2004;114:1475-81. Fracture and maximal lateral rotation of the turbinate were enough for good visualization of a bone defect in the medial portion of the cribriform plate. [Medline]. Makary CA, Zalzal HG, Ramadan J, Ramadan HH. Yadav YR, Yadav S, Sherekar S, Parihar V. A new minimally invasive tubular brain retractor system for surgery of deep intracerebral hematoma. Laryngoscope 2005;115:1774-7. Objective  Schlosser RJ, Wilensky EM, Grady MS, Bolger WE. Sinonasal cerebrospinal fluid leaks: Management of 97 patients over 10 years. Patients Find a Doctor Laryngoscope. [Medline]. Results  Postoperative follow-up lasted from 9 to 42 months, and 20 patients were considered cured. A leak near the middle cranial fossa – near the center of the skull – Gosal JS, Gurmey T, Kursa GK, Salunke P, Gupta SK. Triplanar images of a patient with a left lateral recess meningoencephalocele. Immediate results were good in all patients, but later in the follow-up CSF rhinorrhea reoccurred in 1 female patient. This maintained the release of CSF into the nasal cavity and thus facilitated the fistula's location. Joseph M Scianna, MD   Co-Director of Sinus and Sleep Disorders, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical CenterJoseph M Scianna is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Rhinologic Society, Srinivas Mukkamala, MD  Staff Physician, Department of Otolaryngology-Head and Neck Surgery, Loyola University of Chicago Medical Center. In our group of 21 patients operated on with the endonasal approach, a fistula of the sphenoid sinus wall was revealed in 9 cases. 200 Lothrop Street Refine your search:  DEmanuelli J Oral Maxillofac Surg 2004;62:676-84. Neurosurgery 2009;65 (6 Suppl):65-71; discussion 71-2. [Medline]. 1994 Nov. 111(5):600-5. [Medline]. Endoscopic management of cerebrospinal fluidleaks. Fourteen articles comprising 289 fistulae met the inclusion criteria.  DAKennedy The most recent reports have demonstrated both an increasing prevalence of spontaneous CSF rhinoliquorrhea and a higher rate of spontaneous CSF leaks from fistulas of another etiology.

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