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Anales de Otorrinolaringología Mexicana

2005, Number 4

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Otorrinolaringología 2005; 50 (4)

Endoscopic closure of cerebrospinal fluid fistulas in the anterior cranial fossa

Macías L, Sánchez A, Gutiérrez J

Language: Spanish
References: 36
Page: 92-97
PDF size: 139.45 Kb.


ABSTRACT

Background: The surgical management of cerebrospinal fluid rhinorrhea changed after the introduction of functional endoscopic sinus surgery. The major presenting symptoms include: postural headaches, nausea, vomiting, and diplopia.
Objective: To report the experience of the authors in the treatment of fistulas.
Patients and methods: In a study made from January 2000 to December 2004 we included 24 patients with cerebrospinal fluid fistulas in the anterior cranial fossa. We analyzed the causes, diagnostic methods, indications for surgery, surgical techniques, and surgery-related outcomes with all materials, including: fascia, mucoperichondrial, gelfoam, as well as free and rotated grafts taken from the middle or inferior turbinate.
Results: In 8 patients (33.3%) we used free turbinate grafts for the fistula closure, in 6 (25%) rotated grafts, in 6 more (25%) we used fascia, mucoperichondrial, cartilage, and surgicel, and in 4 (16.6%) fascia, mucoperichondrial, and surgicel. The success rate was of 80% (21 patients), and only 20% (3 patients) developed fistula recurrence. In the last three patients we used fascia, mucoperichondrial, and surgicel for its closure.
Conclusions: The repair of the cerebrospinal fluid rhinorrhea by endonasal endoscopic surgery is safe, effective and is a valid alternative for the intracranial approach.


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