Endoscopic Repair of CSF Rhinorrhea: An Institutional Experience

Mishara, Sarita Kumari and Mathew, George Ani and Paul, Roshna Rose and Asif, Syed Kamran and John, Mary and Varghese, Ajoy Mathew and Kurine, Mary (2016) Endoscopic Repair of CSF Rhinorrhea: An Institutional Experience. Iranian Journal of Otorhinolaryngology, 28 (1). pp. 39-43.

[img]
Preview
Text
IJORL_Volume 28_Issue 1_Pages 39-43.pdf

Download (366kB) | Preview
Official URL: http://ijorl.mums.ac.ir/article_6030.html

Abstract

Introduction: Endoscopic repair is considered the treatment of choice in cerebrospinal fluid (CSF) rhinorrhea. The aim of our study was to analyze the etiopathogenesis of CSF rhinorrhea, the outcome of treatment and the causes of failure in a developing-country setting. Materials and Methods: A retrospective review of patients treated with endoscopic repair for CSF rhinorrhea at a tertiary care hospital in southern India from January 2002 to December 2009 identified 36 patients, the majority of them being women. The defects were closed in three layers using fat, fascia lata and nasal mucosa along with a fibrin sealant in the majority of the patients. Per-operatively, a subarachnoid drain was placed in all patients. Patients were followed up for 1 year. Results: Spontaneous onset of CSF rhinorrhea was noted in 61 of patients. The most common site of leak was found to be the left cribriform plate area. Hence the most common cause of CSF rhinorrhea in our study was spontaneous and the second most common was post-traumatic. Our success rate on the first attempt at endoscopic repair was 100, with a recurrence rate of 6. A large defect, failure of localization of the defect, or other co-morbid conditions such as chronic cough may be the most likely causes of recurrence of leak. Conclusion: Accurate localization of the site of lesion using a high-resolution computed tomography (CT) scan with magnetic resonance imaging (MRI) and confirmation of the site of leak by intraoperative Valsalva maneuver along with multilayered closure of the dural defect and post-operative lumbar drain appear to be essential for the successful endoscopic repair of CSF rhinorrhea.

Item Type: Article
Subjects: WV Otolaryngology
Divisions: Journals > Iranian J Otorhinolaryngology
Depositing User: ijo ijo
Date Deposited: 26 Sep 2017 15:22
Last Modified: 26 Sep 2017 15:22
URI: http://eprints.mums.ac.ir/id/eprint/3329

Actions (login required)

View Item View Item