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Anales de Otorrinolaringología Mexicana

2017, Number 2

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Otorrinolaringología 2017; 62 (2)

Experience in endoscopic treatment of nasal cerebrospinal fluid leak

Vivar-Acevedo E, Luengas-Capetillo R, Sánchez-Castro GF

Language: Spanish
References: 41
Page: 71-80
PDF size: 205.92 Kb.


ABSTRACT

Background: Cerebrospinal fluid (CSF) leak represents an abnormal communication between the barriers that separate the subarachnoid space from the nose and sinuses. It’s classified in spontaneous and traumatic or iatrogenic leaks. Imaging studies are cornerstone for diagnosis and defect location. Studies report up to 90% of successful closure using endoscopic techniques.
Objetive: To describe our experience in surgical management of endoscopic endonasal closure of CSF leak in adult population.
Material and Method: We carried out a descriptive, retrospective study, and used the clinical records of those patients who underwent endoscopic endonasal closure of documented CSF leak, in the department of Otorhinolaryngology of a tertiary medical center (Centro Médico Nacional Siglo XXI, Mexico City) from January 2008 to March 2013.
Results: We included 32 patients, 26 women and 6 men. Spontaneous was the most common etiology occurring in 47% of cases. The most common site of defect location was the lamina cribosa in 53% of cases. The body mass index (BMI) median was 33.3 kg/m2 in patients with leaks of spontaneous etiology. Intrathecal fluorescein was used in 75% of patients. Minor complications appeared in 6% of cases. Success rate for endoscopic closure reached 88%.
Conclusions: Our success rate is similar to previous international reports. Significant statistic association between BMI and spontaneous CSF leak was found. It was not possible to determine association between postoperative care and recurrence.


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