Re: What I do if things go wrong: up-to-date expert opinion referencing the best evidence available on intraoperative cerebrospinal fluid leak during endoscopic sinus surgery

2013 ◽  
Vol 38 (4) ◽  
pp. 353-353
Author(s):  
R.B. Townsley ◽  
M. Yaneza ◽  
O.J. Hilmi
Keyword(s):  
Cerebrospinal Fluid ◽  
Expert Opinion ◽  
Endoscopic Sinus Surgery ◽  
Cerebrospinal Fluid Leak ◽  
Sinus Surgery ◽  
Fluid Leak

Sinus anatomy associated with inadvertent cerebrospinal fluid leak during functional endoscopic sinus surgery

2012 ◽  
Vol 122 (7) ◽  
pp. 1446-1449 ◽  
Author(s):  
Chase M. Heaton ◽  
Andrew N. Goldberg ◽  
Steven D. Pletcher ◽  
Christine M. Glastonbury
Keyword(s):  
Cerebrospinal Fluid ◽  
Endoscopic Sinus Surgery ◽  
Cerebrospinal Fluid Leak ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fluid Leak

scholarly journals Repair of Cerebrospinal Fluid Leak After Functional Endoscopy Sinus Surgery

2017 ◽  
Vol 1 (5) ◽  
Author(s):  
Mohamad I Sapta ◽  
Teresa L Wargasetia
Keyword(s):  
Cerebrospinal Fluid ◽  
Endoscopic Sinus Surgery ◽  
Cerebrospinal Fluid Leak ◽  
Lamina Cribrosa ◽  
Clinical Findings ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Computed Tomography Scanning ◽  
Fluid Leak

Cerebrospinal fluid (CSF) leak is one of Functional Endoscopic Sinus Surgery (FESS)complications. Since 2001, it was reported that there is one case of CSF leak as FESScomplication in ENT-HN Department, Faculty of Medicine, Maranatha Christian University -Immanuel Hospital in Bandung. The purpose of this case report is present clinical findings andmanagement of CSF leak as FESS complication. A-45 year old male with headache as chiefcomplain after undergone FESS five days before. There was a clear rhinorrhea running frompatient’s right nose. In nasoendoscopic examination, it was showed there was a defect in laminacribrosa. The result of paranasal sinus computed tomography scanning showed an air columnin brain ventricular system. The defect in lamina cribrosa was repaired by transnasalendoscopic using materials such as surgicel, cartilages, and fat tissues. The conclusion is weroll out one case about repair of CSF leak as a FESS complication and it was done with a goodresult.Keywords: cerebrospinal fluid leak, functional endoscopic sinus surgery

scholarly journals Visualized Ethmoid Roof Cerebrospinal Fluid Leak during Frontal Balloon Sinuplasty

2018 ◽  
Vol 97 (8) ◽  
pp. E34-E38 ◽  
Author(s):  
Navdeep R. Sayal ◽  
Eytan Keidar ◽  
Shant Korkigian
Keyword(s):  
Cerebrospinal Fluid ◽  
Balloon Dilation ◽  
Major Complication ◽  
Cerebrospinal Fluid Leak ◽  
Collagen Matrix ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Safe Alternative ◽  
Revision Sinus Surgery ◽  
Fluid Leak

Balloon sinus dilation (BSD) is generally accepted as a safe alternative to traditional sinus surgery. It is a unique technique designed to potentially minimize complications associated with traditional functional endoscopic sinus surgery (FESS). We present a case in which a 65-year-old man experienced a cerebrospinal fluid (CSF) leak in the ethmoid roof that was visualized instantly after balloon dilation in a revision sinus surgery. In this case report, we discuss the causes of CSF leaks and explain in detail the immediate endoscopic repair with a collagen matrix. Also, literature is reviewed on the safety of BSD versus traditional FESS. Postoperative-ly, the patient has been without CSF leak and remains symptom free. CSF leak is a rare but major complication during both FESS and BSD. As BSD use increases, its complication profile will become clearer when used alone, in conjunction with FESS, and/or during revision surgery. Although BSD is considered a benign procedure, one should be cautious when using it in revision sinus surgery.

Improving paranasal sinus computed tomography reporting prior to functional endoscopic sinus surgery – an ENT-UK panel perspective

2016 ◽  
Vol 130 (10) ◽  
pp. 962-966 ◽  
Author(s):  
S G Mistry ◽  
D R Strachan ◽  
E L Loney
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Image Interpretation ◽  
Cerebrospinal Fluid Leak ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Carotid Canal ◽  
Radiological Report ◽  
Fluid Leak ◽  
Canal Dehiscence

AbstractBackground:Functional endoscopic sinus surgery is recognised to have a significant complication profile (e.g. blindness, cerebrospinal fluid leak and intracranial sepsis). Pre-operative computed tomography imaging is considered mandatory for surgical planning to reduce intra-operative risk. A radiological report is the ‘gold standard’ in image interpretation; however, because of a lack of otolaryngological or radiological guidance, its contents may be variable. By surveying practising otolaryngologists, this study aimed to provide some guidance which may be used by radiologists to produce more surgically relevant radiological reports.Method:A prospective questionnaire was distributed to the ENT-UK panel.Results:A total of 117 consultant members of the panel completed the survey. Twenty-nine per cent indicated that they were uncomfortable interpreting all areas of the computed tomography scan. Greatest importance was given to areas including the ethmoid roof (dehiscence, asymmetry and angle), lamina papyracea (dehiscence) and sphenoid sinus (carotid canal dehiscence and optic nerve relationships).Conclusion:Functional endoscopic sinus surgery is commonly performed by non-subspecialist rhinologists. The information obtained from this study can be used by radiologists to improve report relevance, particularly for the generalist ENT surgeon. This contributes to improving patient safety and helps avoid medicolegal litigation when complications arise.

Management of Cerebral Vascular Structures during Endoscopic Treatment of Encephaloceles: A Clinical Report

2006 ◽  
Vol 115 (3) ◽  
pp. 167-170 ◽  
Author(s):  
William E. Bolger
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Endoscopic Treatment ◽  
Cerebrospinal Fluid Leak ◽  
Sinus Surgery ◽  
Clinical Report ◽  
Management Options ◽  
Cerebral Vessel ◽  
Fluid Leak ◽  
Cerebral Vascular

Objectives: Otolaryngologists are increasingly being called upon to treat patients with cerebrospinal fluid leak and encephaloceles. The endoscopic approach to the skull base through the nose and paranasal sinuses has proven effective and is well tolerated by patients. With its more widespread and frequent use, unusual cases and potential complications are becoming more apparent. Methods: Treatment of Two clinical cases in which a cerebral vascular structure was encountered during endoscopic treatment of an encephalocele is presented, and the condition is reviewed. Results: Two patients presented after a skull base injury that occurred during endoscopic sinus surgery. In each case the initial treating surgeon attempted endoscopic repair of a cerebrospinal fluid leak, but the repair failed and the leak persisted. Upon referral to the author, in each case, a traumatic encephalocele with an active leak was apparent, and during repair a cerebral vessel was encountered. It appeared that the vessel had been “pulled down” into the skull base defect with the encephalocele's migration into the sinonasal cavity. Conclusions: This unusual clinical condition is discussed along with the potential complications that can result from it. Otolaryngologists who treat encephaloceles should be aware of the possibility of encountering a cerebral vessel and should understand the potential complications and management options.

scholarly journals Cerebrospinal Fluid Leak - Prevalence in Traumatic Head Injury at a Tertiary Care Center

2019 ◽  
Vol 8 (3) ◽  
pp. 123-126
Author(s):  
Muhammad Junaid ◽  
Asad Nabi ◽  
Muhammad Aslam Khan ◽  
Muhammad Umair
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Cerebrospinal Fluid Leak ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Age Group ◽  
Traumatic Head Injury ◽  
Acute Trauma ◽  
Traumatic Head ◽  
Fluid Leak

Background: Cerebrospinal fluid circulates around the surface of brain and spinal cord and through the brain’s ventricles. CSF leak is a condition that occurs when the CSF leaks through a defect in the dura or skull and out through the ear or nose. The most common causes of CSF leak include head injury, brain and sinus surgery. The objective of this study was to determine the frequencies of post-traumatic cerebrospinal fluid leak in traumatic head injury. Material and Methods: A descriptive case series was carried out in the Department of Neurosurgery, Hayatabad Medical Complex, Peshawar for a period of 1 year, from 1st February 2016 to 31st January 2017. A total of 422 patients presenting within 48 hours of acute trauma to the head were included in a consecutive manner and followed up till 7th day to determine the CSF leak. Results: The mean age group of our sample was 37.37 + 12.3 years of which 79.6% were male patients and 20.4% female patients. Most of the patients (55.5%) were ≤ 40 years of age. CSF leak was observed in 5.2% of patients, with otorrhea seen in 2.1% patients and rhinorrhea in 3.1% patients, respectively. Conclusion: CSF leak is quite common in our population after acute trauma to the head. The high prevalence may be due to high frequency of accidents in our society with high velocity impact and more commonly seen in the younger age group (≤ 40 years).

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