Transsphenoidal endoscopic appro ach in the treat ment of spontaneous cerebrospinal fluid (CSF) leak

Abstract

Introduction. Spontaneous nasal liquorrhea is a pathological condition associated with defect between nasal cavity and intracranial structures that lead to the expiration of the CSF from the nasal cavity.The objective is to evaluate the effectiveness of endoscopic endonasal approach in the CSF leak treatment.Material and methods. For the period from 2008 to 2018, 38 patients with spontaneous nasal liquorrhea were examined and treated in Pavlov First Saint Petersburg State Medical University, the clinic of neurosurgery of Kirov Medical Institute and Almazov National Medical Research Centre. All patients underwent plastic surgery of the CSF fistula by endoscopic endonasal aproach.Results. Only in 4 cases, there was a large defect, the failure of the closure of which required repeated surgical intervention in 1–2 weeks after the initial operation.Conclusion. The use of autologous tissues (muscle or fat autograft) is the method of choice for repeated surgical plastics of the cerebrospinal fluid fistula or in a large size defect (more than 5 mm).

Keywords

• nasal liquorrhea
• skull base
• autograft