The Role of Trans-Cranial Approach in the Management of Spontaneous CSF Fistula

• 作者: Mohamed Adel Ghoneim Waleed Abbass
• 来源期刊: 现代神经外科学进展(英文)
• 学科: 医学
• 关键词: CSF Trans-Cranial INTRA DURAL
• 年，卷（期）: xdsjwkxjzyw,（2）
• 页码范围: 230-236
• 页数: 7页
• 分类号: R73

摘要

Background: Spontaneous descent of the CSF (Cerebrospinal fluid) from the nose is called rhinorrhea. The causes are defects in bones of the base or meningeal tear. The surgical management is still a challenge. The surgical repair is a must to prevent the complication which could be brain abscess, meningitis, or pneumocephalus. The available surgical management is either transnasal, or transcranial. The endonasal route represents an easy access but equally aggressive alternative and of limited access. Objective: We reviewed the clinical outcomes of thirteen cases of spontaneous CSF leakage managed by transcranial intradural approach. Patients and Methods: This is a retrospective study about the records of 13 patients who underwent transcranial intradural approach as a surgical management for spontaneous CSF rhinorrhea in our department in the period between November 2017 and October 2019. Results: CSF leakage stopped after initial surgery in 12 of 13 patients, giving a success rate of 92.3%. The remaining case did not agree for new surgery and the case resolved without surgery for this patient. Postoperative complications included superficial wound infection in one patient, and anosmia in one patient. No other neurological problems were encountered over the ten-months’ follow-up period. Conclusion: The transcranial route is the treatment of choice for patients with anterior cranial fossa spontaneous CSF rhinorrhea. A satisfactory surgical outcome depends on exact diagnosis, proper operative approach, and the surgeon’s skills and experience.