J Korean Neurotraumatol Soc. 2006 Jun;2(1):26-30. English.
Published online Jun 30, 2006.
Copyright © 2006 Journal of Korean Neurotraumatology Society
Original Article

Endoscopic Endonasal Repair of Cerebrospinal Fluid Rhinorrhea by The Combined Overlay and Underlay Techniques

Dae Sung Jung, M.D., Byung Chan Jeon, M.D., Yong Sook Park, M.D. and Hyung Suk Oh, M.D.
    • Department of Neurosurgery, Kosin University Gospel Hospital & College of Medicine, Busan, Korea.

Abstract

Objective

This study is aimed to describe the efficacy of endoscopic transnasal repair of cerebrospinal fluid (CSF) rhinorrhea and anterior skull base defect using a combined overlay and underlay techniques.

Methods

The authors have performed 5 endoscopic procedures in the 3 patients with CSF rhinorrhea. The etiologies of the CSF leaks were 2 traumatic brain injuries and 1 iatrogenic one. All patients underwent preoperatively magnetic resonance imaging (MRI) scan with intrathecal infusion of Gadolinium. The repair using the overlay or combination technique was done with fibrin glue, strips of fat, and septal cartilage or porous polyethylene implant (Medpor).

Results

All CSF leaks were found out during endoscopic procedures. One patient underwent an overlay technique using a rotated middle turbinate flap had recurrent CSF leakage, which was successfully treated with the combination technique. Other two patients exhibiting 3 CSF leakages were successfully treated with the combination techniques. Any major complication was not seen.

Conclusion

The endoscopic transnasal repair with free grafts by the combined overlay and underlay techniques is a safe and successful method for the treatment of CSF leaks.

Keywords
Cerebrospinal fluid rhinorrhea; Endoscopic surgery; Endonasal


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