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Purely endoscopic pterional extradural approach: A novel technique for repair of cerebrospinal fluid rhinorrhea.

Sinha AK, Goyal S - J Neurosci Rural Pract (2016 Apr-Jun)

Bottom Line: There was no requirement of blood transfusion in any case.All patients had a cessation of CSF leak in the postoperative period, and there was no recurrence.There was no evidence of frontal lobe retraction injury in any of these patients, and no fresh neurological deficit was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India.

ABSTRACT

Study design: Retrospective descriptive study of an innovative surgical technique.

Objective: To assess the feasibility and success of repair of transfrontal sinus cerebrospinal fluid (CSF) rhinorrhea through pterional transcranial extradural approach using endoscope.

Summary of background data: Repair of CSF rhinorrhea has seen advancement with the evolution of endoscopic transnasal techniques. However, leaks from defect in the posterior wall of frontal sinus still remain a challenge for the skull base surgeons and requires conventional craniotomy more often. We describe a novel technique to repair these leaks by purely endoscopic pterional extradural (PEPE) approach thereby avoiding complications associated with conventional craniotomy and endoscopic transnasal approaches.

Materials and methods: Thirty-five patients with traumatic CSF rhinorrhea from the posterior wall of frontal sinus underwent repair with the present technique. They were followed up for 6-18 months and were evaluated for feasibility of procedure, recurrence of leak, and occurrence of the fresh neurological deficit.

Results: Thirty-five patients underwent CSF rhinorrhea repair using the above technique. The procedure was accomplished in all patients without any intraoperative complications. There was no requirement of blood transfusion in any case. All patients had a cessation of CSF leak in the postoperative period, and there was no recurrence. There was no evidence of frontal lobe retraction injury in any of these patients, and no fresh neurological deficit was observed.

Conclusion: This PEPE approach to repair CSF leak through the posterior wall of the frontal sinus is a novel technique in which we can avoid disadvantages associated with both conventional craniotomy as well as transnasal endoscopic approaches.

No MeSH data available.


Related in: MedlinePlus

Immediate postoperative computed tomography scan of the patient who underwent repair of cerebrospinal fluid leak through purely endoscopic pterional extradural approach did not show any retractional injury to frontal lobe
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Figure 4: Immediate postoperative computed tomography scan of the patient who underwent repair of cerebrospinal fluid leak through purely endoscopic pterional extradural approach did not show any retractional injury to frontal lobe

Mentions: Postprocedure CT scan was routinely done after 48 h which did not reveal any insult to the frontal lobe due to retraction [Figure 4].


Purely endoscopic pterional extradural approach: A novel technique for repair of cerebrospinal fluid rhinorrhea.

Sinha AK, Goyal S - J Neurosci Rural Pract (2016 Apr-Jun)

Immediate postoperative computed tomography scan of the patient who underwent repair of cerebrospinal fluid leak through purely endoscopic pterional extradural approach did not show any retractional injury to frontal lobe
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4821949&req=5

Figure 4: Immediate postoperative computed tomography scan of the patient who underwent repair of cerebrospinal fluid leak through purely endoscopic pterional extradural approach did not show any retractional injury to frontal lobe
Mentions: Postprocedure CT scan was routinely done after 48 h which did not reveal any insult to the frontal lobe due to retraction [Figure 4].

Bottom Line: There was no requirement of blood transfusion in any case.All patients had a cessation of CSF leak in the postoperative period, and there was no recurrence.There was no evidence of frontal lobe retraction injury in any of these patients, and no fresh neurological deficit was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India.

ABSTRACT

Study design: Retrospective descriptive study of an innovative surgical technique.

Objective: To assess the feasibility and success of repair of transfrontal sinus cerebrospinal fluid (CSF) rhinorrhea through pterional transcranial extradural approach using endoscope.

Summary of background data: Repair of CSF rhinorrhea has seen advancement with the evolution of endoscopic transnasal techniques. However, leaks from defect in the posterior wall of frontal sinus still remain a challenge for the skull base surgeons and requires conventional craniotomy more often. We describe a novel technique to repair these leaks by purely endoscopic pterional extradural (PEPE) approach thereby avoiding complications associated with conventional craniotomy and endoscopic transnasal approaches.

Materials and methods: Thirty-five patients with traumatic CSF rhinorrhea from the posterior wall of frontal sinus underwent repair with the present technique. They were followed up for 6-18 months and were evaluated for feasibility of procedure, recurrence of leak, and occurrence of the fresh neurological deficit.

Results: Thirty-five patients underwent CSF rhinorrhea repair using the above technique. The procedure was accomplished in all patients without any intraoperative complications. There was no requirement of blood transfusion in any case. All patients had a cessation of CSF leak in the postoperative period, and there was no recurrence. There was no evidence of frontal lobe retraction injury in any of these patients, and no fresh neurological deficit was observed.

Conclusion: This PEPE approach to repair CSF leak through the posterior wall of the frontal sinus is a novel technique in which we can avoid disadvantages associated with both conventional craniotomy as well as transnasal endoscopic approaches.

No MeSH data available.


Related in: MedlinePlus