Fifteen years of experience in plastic liquor fistulas using high-intensity laser radiation

Abstract

Introduction. The need to close liquor fistulas as early as possible is associated with a high risk of intracranial complications. Certain difficulties in closing bone defects are due to the variability of the exact localization of the fistulous canal, the choice of the surgical approach, and the reliability of the plastic material. The literature describes various methods for eliminating basal liquorrhea, however, the advantage of none of them has not been proven, which determines the relevance of the search for new methods.Objective. Based on the analysis of long-term results, to study the efficiency of plastic closure of cerebrospinal fluid fistulas using high-intensity laser radiation.Materials and methods. An analysis of 15 years of experience in studying the effectiveness of plastic closure of cerebrospinal fluid fistulas in 126 operated patients with basal liquorrhea was carried out. The duration of the disease ranged from 2 months to 1.5 years. The main group consisted of 94 patients who underwent plastic closure of CSF fistulas using high-intensity laser radiation with a wavelength of 0.97 pm and a power of 2.5-3.5 W. The control group consisted of 32 patients who did not receive coherent laser radiation. In addition to the generally accepted methods of postoperative management, low-frequency ultrasonic cavitation irrigation of the operated cavities was used to accelerate the reparative processes in all patients.Results and discussion. The average follow-up period after surgery was over 13 years. When comparing the results of treatment, the main criterion for evaluating the effectiveness of the operation was the frequency of relapses. In 15 (12.3%) cases, a relapse was noted, of which 5 (3.71%) were patients in the main group and in 10 (8.32%) patients in the control group, who were closed by repeated surgeryConclusion. The clinical features of the basal liquorrhea include the variability in the localization of the fistulous canals, certain difficulties in their detection, a wide variety of plastic closure methods, and a high percentage of relapses. A prospective uncontrolled study has shown that this method of CSF fistula plasty using improves the efficiency of surgical treatment.

Keywords

• basal liquorrhea
• nasal liquorrhea
• cerebrospinal fluid fistula
• ct cisternography
• endoscopic endonasal surgery
• high-intensity laser