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Spontaneous cerebrospinal fluid leaks in the anterior skull base: a surgical challenge

Published online by Cambridge University Press:  24 April 2015

G Martínez-Capoccioni ,
R Serramito-García ,
B Huertas-Pardo ,
A García-Allut  and
C Martín-Martín
G Martínez-Capoccioni*
Affiliation:
Service of ENT–Head and Neck Surgery, Servizo Galego de Saúde, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
R Serramito-García
Affiliation:
Service of Neurosurgery, Servizo Galego de Saúde, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
B Huertas-Pardo
Affiliation:
Service of ENT–Head and Neck Surgery, Servizo Galego de Saúde, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
A García-Allut
Affiliation:
Service of Neurosurgery, Servizo Galego de Saúde, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
C Martín-Martín
Affiliation:
Service of ENT–Head and Neck Surgery, Servizo Galego de Saúde, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
*
Address for correspondence: Dr G Martínez-Capoccioni, Servizo Galego de Saúde, Service of ENT–Head and Neck Surgery, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain E-mail: Gabriel.Adolfo.Martinez.Capoccioni@sergas.es
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Abstract

Objective:

This retrospective study aimed to evaluate the effective closure rate for spontaneous cerebrospinal fluid leaks with functional endoscopic sinus surgery and identify patient characteristics that may be associated with a need for additional therapy.

Method:

A retrospective analysis of patients with spontaneous cerebrospinal fluid leaks was performed. Data on the nature of presentation, patient body mass index, defect location and size, intracranial pressure, clinical follow up, and complications were collected.

Results:

Twenty-five patients had spontaneous cerebrospinal fluid leaks with evidence of idiopathic intracranial hypertension. The most common sites were the cribriform plate, followed by the ethmoid roof and sphenoid lateral pterygoid recess. All patients underwent endonasal endoscopic surgery to repair the defect. Post-operatively, all patients underwent lumbar drainage and acetazolamide therapy.

Conclusion:

Spontaneous cerebrospinal fluid leaks represent a surgical challenge because of their high recurrence rates. The most important factor for obtaining a successful repair in these patients is reducing their intracranial pressure through nutritional, medical or surgical means.

Keywords

Cerebrospinal Fluid LeakCerebrospinal Fluid RhinorrheaEndoscopic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 4 , April 2015 , pp. 358 - 364
Copyright
Copyright © JLO (1984) Limited 2015 

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