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Cerebrospinal fluid rhinorrhoea as a complication of endoscopic endonasal reduction of blowout fractures

  • D-G Lee (a1) (a2), K-S Cho (a1) (a2), H-J Kim (a3) and H-J Roh (a4)

Abstract

Background:

Unless the orbital contents are supported, the insertion of nasal packing material during endoscopic endonasal surgery may cause serious intracranial complications such as cerebrospinal fluid leakage.

Methods:

Case report and literature review.

Results:

We report a patient with iatrogenic cerebrospinal fluid rhinorrhoea caused by intracranial entry of a Silastic sheet inserted into the nasal cavity. This skull defect and the surrounding skull base were successfully reconstructed in a multilayer fashion via an endoscopic endonasal approach.

Conclusion:

This case highlights the need for caution when inserting nasal packing material. During endoscopic endonasal reduction of blowout fractures, great care must be taken to support the orbital contents, in order to avoid serious intracranial complications such as cerebrospinal fluid leakage.

Copyright

Corresponding author

Address for correspondence: Dr Kyu-Sup Cho, Department of Otorhinolaryngology, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-gu, Busan 602-739, South Korea Fax: +82 51 246 8668, E-mail: choks@pusan.ac.kr

References

Hide All
1Hinohira, Y, Takahashi, H, Komori, M, Shiraishi, A. Endoscopic endonasal management of medial orbital blowout fractures. Facial Plast Surg 2009;25:1722
2Mohadjer, Y, Hartstein, ME. Endoscopic orbital fracture repair. Otolaryngol Clin North Am 2006;39:1049–57
3Hinohira, Y, Yumoto, E, Shimamura, I. Endoscopic endonasal reduction of blowout fractures of the orbital floor. Otolaryngol Head Neck Surg 2005;133:741–7
4Wu, W, Yan, W, Cannon, PS, Jiang, AC. Endoscopic transethmoidal and transconjunctival inferior fornix approaches for repairing the combined medial wall and orbital floor blowout fractures. J Craniofac Surg 2011;22:537–42
5Burnstine, MA. Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis. Ophthalmology 2002;109:1207–10
6Park, CH, Choi, DJ, Lee, JH, Hong, SM, Kwon, TK, Joung, HH et al. Endoscopic reduction of medial orbital wall fractures using the rolled silastic sheet technique. J Trauma 2009;66:1421–4

Keywords

Cerebrospinal fluid rhinorrhoea as a complication of endoscopic endonasal reduction of blowout fractures

  • D-G Lee (a1) (a2), K-S Cho (a1) (a2), H-J Kim (a3) and H-J Roh (a4)

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