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Skull Base 2001; 11(1): 047-058
DOI: 10.1055/s-2001-12787
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Endonasal Endoscopic Closure of Cerebrospinal Fluid Rhinorrhea

S. Schmerber1 , Ch. Righini1 , J.-P. Lavieille1 , J.-G. Passagia2 , E. Reyt1
  • 1Department of Ear, Nose, and Throat Surgery, Grenoble Hospital, Grenoble, France
  • 2Department of Neurosurgery, Grenoble Hospital, Grenoble, France
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

The authors review their experience with endoscopic repair of skull base defects associated with cerebrospinal fluid (CSF) rhinorrhea involving the paranasal sinuses. A total of 22 patients was treated endoscopically between 1992 and 1998. The repair method consisted of closure of the CSF fistula with a free autologous abdominal fat graft and fibrin glue, supported with a sheet of silastic. The primary closure rate was 82% (18/22), and the overall closure rate was 95.5% (21/22) without recurrence or complications within an average follow-up of 5 years (14-83 months). A single patient still complains of cerebrospinal rhinorrhea, although this was never proved by any clinical, endoscopic, or biological (β2-transferrin) examination. The repair of ethmoidal-sphenoidal cerebrospinal fluid fistulae by endonasal endoscopic surgery is an excellent technique, both safe and effective. Fat is a material of choice, as it is tight and resists infection well. The technique and indications for endoscopic management of cerebrospinal fluid leaks are discussed.

KEYWORD

Cerebrospinal fluid rhinorrhea - fat graft - endoscopic treatment - anterior cranial fossa - ethmoid - sphenoidal sinus - MRI cisternography

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