Endoscopic Endonasal Approaches For Repair Of Cerebrospinal Fluid Leaks: Nine-Year Experience

Author:

Locatelli Davide1,Rampa Federico1,Acchiardi Ilaria1,Bignami Maurizio2,Bernardi Francesca De2,Castelnuovo Paolo2

Affiliation:

1. Department of Neurosurgery, Science Research and Cure Institute Policlinico “S. Matteo,” University of Pavia, Pavia, Italy

2. Department of Otolaryngology, Ospedale di Circolo, University of Insubria, Varese, Italy

Abstract

Abstract Objective: To describe surgical endoscopic experience in the repair of cerebrospinal fluid leaks treated by transnasal approaches. Methods: Different surgical approaches and techniques in the repair of cranial base defects are reviewed in a series of 135 patients. Results: Success rate at first attempt was 93.3%. Only 9 patients (6.7%) needed a second surgical repair, and in one patient, a coronal approach with frontal craniotomy was necessary. In the other eight cases, an endoscopic procedure was chosen. Two patients needed a third endonasal endoscopic surgical repair, with successful outcome. Conclusion: The target of endoscopic endonasal technique in the repair of cerebrospinal fluid leaks is to ensure a stable duraplasty with the least invasive approach avoiding craniotomy. A correct diagnosis surely allows the choice of the best treatment, surgical approach, graft, and technique. Our multidisciplinary approach to this pathology during these years has been essential to gain our challenging results.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Clinical Neurology,Surgery

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