csf rhinorrhea surgery recovery

Share cases and questions with Physicians on Medscape consult.  et al Spontaneous cerebrospinal fluid rhinorrhea: evolving concepts in diagnosis and surgical management based on the Mayo Clinic experience from 1970 through 1981. J Neurosurg 2010;113:961-6. Twenty-one consecutive patients who presented with spontaneous CSF leak and underwent endonasal endoscopic surgery from January 1999 through December 2001. The lumbar drain was kept for 5 to 8 days and CSF was evacuated by the drain at the rate of 5 mL/h. [Medline]. treatment of CSF leaks depends on the location of the leak. Etiological factors of this disease may include obesity; innate skull base malformations; overpneumatized sphenoid sinus, particularly its lateral extensions; and empty sella syndrome. [Full Text].  PKeerl Consensus statements are issued by a panel of experts and are based on the latest available scientific evidence and clinical experience, constituting the key clinical manuals for diagnosing and treating medical conditions. Get free access to newly published articles. Note the fluid level (A) and a small meningocele in the lateral part of the sinus (B). J Laryngol Otol 1997;111:1042-6. Septal cartilage was used exclusively for closure of large bone defects in the roofs of the ethmoidal sinuses. Becker SS, Duncavage JA, Russell PT. A specific form of secondary traumatic CSF leak is iatrogenic liquorrhea, which occurs not infrequently during skull base and endonasal sinus surgery. Pittsburgh, PA 15213 This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach areas or previously inoperable tumors. Academic neurosurgical hospital. CSF rhinorrhoea: the place of endoscopic sinus surgery. Fracture and maximal lateral rotation of the turbinate were enough for good visualization of a bone defect in the medial portion of the cribriform plate. Asian J Surg 2004;27:39-42. Presutti L, Mattioli F, Villari D, Marchioni D, Alicandri-Ciufelli M. Transnasal endoscopic treatment of cerebrospinal fluid leak: 17 years' experience. If you log out, you will be required to enter your username and password the next time you visit. The 15 women and 6 men who formed the latter group (our study group) were between 15 and 64 years old and only 5 of them (4 women and 1 man) were obese. Management of cerebrospinal fluid rhinorrhea: The Medical College of Wisconsin experience. Landeiro JA, Flores MS, Lázaro BC, Melo MH. Of these, 4 were operated on with the transcranial approach and 21 underwent endonasal endoscopic surgery. encoded search term (What are the surgical options for repair of cerebrospinal fluid (CSF) leaks in CSF rhinorrhea?) For fistulas located in the lateral part of the cribriform plate and in the fovea ethmoidalis we rotated the middle turbinate and cut a wide opening in the ethmoid sinus using the straight 3.5-mm blade of a microdebrider (Hummer 2; Stryker Endoscopy, Santa Clara, Calif). located, small pieces of tissue from the nasal lining are placed on the site. [Full Text]. Laryngoscope. Some patients can develop spontaneous CSF rhinorrhea. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL2Fuc3dlcnMvODYxMTI2LTEwMjQ1Ni93aGF0LWFyZS10aGUtc3VyZ2ljYWwtb3B0aW9ucy1mb3ItcmVwYWlyLW9mLWNlcmVicm9zcGluYWwtZmx1aWQtY3NmLWxlYWtzLWluLWNzZi1yaGlub3JyaGVh. Postoperative follow-up lasted from 9 to 42 months, and 20 patients were considered cured. An opening in the membranes makes the nervous system more susceptible to infection. [Medline]. Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations.  LLoughran Sinonasal cerebrospinal fluid leaks: Management of 97 patients over 10 years. Platt MP, Parnes SM. Diseases & Conditions, 2002 James Stankiewicz, MD is a member of the following medical societies: American College of SurgeonsDisclosure: Nothing to disclose. In our series, 20 patients were treated successfully and the only recurrence was a case where the fistula was in this particular location. Ryall RG, Peacock MK, Simpson DA. Intensive Care Unit (neuro ICU), A headache that worsens upon sitting up and eases upon lying down, Clear drainage from the ear (CSF otorrhea) or the nose (CSF rhinorrhea) when Fourteen articles comprising 289 fistulae met the inclusion criteria. The dura Cerebrospinal pressure was measured and a lumbar drain was placed—with care taken to avoid evacuation of a significant amount of CSF. Dodson EE, Gross CW, Swerdloff JL, et al. Int Forum Allergy Rhinol. Ear Nose Throat J . Corresponding author and reprints: Andrey S. Lopatin, MD, Department of Ear, Nose, and Throat, Central Hospital, Presidential Medical Center, PO Box 4, 121614 Moscow, Russia (e-mail: asl@cch.pmc.ru). Material and methods: A literature search was performed on PubMed, Medline and Cochrane Central databases, independently by two of the authors, of all studies reporting the outcomes of CSF rhinorrhoea repair, published until the 1st June 2014, using keywords Cerebrospinal fluid leak, CSF leak, CSF fistula, CSF leak or fistula repair, endoscopic sinus surgery or ESS complications. Tolley Patients In contrast, primary CSF rhinorrhea has been usually recognized as a rare condition presenting diagnostic and therapeutic challenges. A diagnosis of spontaneous CSF rhinorrhea was confirmed in the remaining 25 patients. By continuing to use our site, or clicking "Continue," you are agreeing to our, 2020 American Medical Association. 800-533-8762, © 2020 UPMC I Affiliated with the University of Pittsburgh Schools of the Health Sciences, Supplemental content provided by Healthwise, Incorporated.  AP Study on spontaneous CSF rhinorrhoea, its etiology and management. [Medline]. An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS), Endoscopic management of cerebrospinal fluid rhinorrhea Martin TJ, Loehrl TA. Strek P, Zagólski O, Skladzie J, Kurzyflski M, Oleg K, Konior M. Dusick JR, Mattozo CA, Esposito F, Kelly DF. There were no postoperative complications. Bibas AG, Skia B, Hickey SA. [Medline]. Southwestern specialists offer rapid, accurate diagnosis of this dangerous New Patient Appointment Please confirm that you would like to log out of Medscape. Nyquist GG, Anand VK, Mehra S, Kacker A, Schwartz TH. lifting (no greater than 10 pounds), and nose blowing. Keywords: Cerebrospinal fluid pressure, cerebrospinal fluid rhinorrhea, cerebrospinal fluid, endoscopic surgical procedure, skull base. neurosurgery program in North Texas. Curr Opin Otolaryngol Head Neck Surg 2004;12:404-7. J Neurosurg. In cases where CT data were not conclusive, immediate preoperative endoscopy permitted the approximate location of the bone defect and the selection of a tentative surgical technique. Marks SC. Cochrane Database Syst Rev. [Medline]. Since St Clair Thompson's first description of 20 cases of nontraumatic rhinoliquorrhea in the late 1800s,3 patients with a primary (spontaneous) CSF leak have presented a diagnostic and therapeutic challenge. 6th and 7th Floor, Neuroscience Nishioka H, Izawa H, Ikeda Y, Namatame H, Fukami S, Haraoka J. Dural suturing for repair of cerebrospinal fluid leak in transnasal transsphenoidal surgery. The international consensus statements were presented during the international Santo-Rhino II workshop, attended by scientists from 28 countries, including the most highly acclaimed endoscopic surgeons (ENT and neurosurgeons) from Europe, North and South America, and Australia. Auris Nasus Larynx 2007;34:515-8. Byrne JV, Ingram CE, MacVicar D, et al. El-Banhawy OA, Halaka AN, El-Hafiz Shehab El-Dien A, Ayad H. Subcranial transnasal repair of cerebrospinal fluid rhinorrhea with free autologous grafts by the combined overlay and underlay techniques. If it contains beta-2-transferrin — a protein specific to CSF — he or she can make a positive diagnosis. Your doctor may instruct you to rest and give you pain relievers for the headache. Triplanar images help to identify and conceptualize the location of this lateral recess encephalocele. Castelnuovo P, Mauri S, Locatelli D, Emanuelli E, Delù G, Giulio GD. Use of sodium fluorescein solution for detection of cerebrospinal fluid fistulas: An analysis of 420 administrations and reported complications in Europe and the United States. Some leaks could be spontaneous without any specific etiology. Marchiano E, Carniol ET, Guzman DE, Raikundalia MD, Baredes S, Eloy JA. Br J Neurosurg. Cerebrospinal fluid dynamics in skull base surgery.  MMFatterpekar Cerebrospinal fluid (CSF) rhinorrhea is a rare but potentially devastating condition that can lead to significant morbidity and mortality for the patient. Managing cerebrospinal fluid rhinorrhea after lateral skull base surgery via endoscopic endonasal eustachian tube closure. The last 2 etiological factors may coexist. Your doctor may instruct you to rest and give you pain relievers for the headache. In the case of a meningocele, the latter was removed and the bone edges of the fistula were carefully skeletonized. Neurosurgery Objective To analyze possible etiological factors of spontaneous cerebrospinal fluid (CSF) rhinorrhea and to assess the outcomes of endonasal endoscopic repair.. Design Retrospective study.. Beta-2 transferrin test confirms the diagnosis. Normally 2016 Nov. 6 (11):1126-30. Most cases of CSF rhinorrhea occur after major accidents where the bones of the face and skull experience significant trauma. Br J Neurosurg. In a person with CSF rhinorrhea immediately after trauma, apart from surgery, the recommended approach is conservative management. Ann Emerg Med. Otolaryngol Head Neck Surg 2009;140:826-33. Customize your JAMA Network experience by selecting one or more topics from the list below.  M Etiologic factors in primary CSF rhinorrhea. Seth R, Rajasekaran K, Benninger MS, Batra PS. Kreatsoulas DC, Shah VS, Otto BA, Carrau RL, Prevedello DM, Hardesty DA. 2015 Mar-Apr. Rhinology 2009;47:362-8. Clin Nucl Med 2000;25:634-5. Each patient’s Schlosser RJ, Woodworth BA, Wilensky EM, Grady MS, Bolger WE. Iatrogenic CSF rhinorrhea occur most frequently as complications to functional endoscopic sinus surgery with the cribriform plate and ethmoid bone being the most commonly injured, followed by the frontal and sphenoid sinuses 5). 1994 Nov. 111(5):600-5. [Medline] . 2000 Jul. McMains KC, Gross CW, Kountakis SE. In the 4 remaining cases, the bone defect itself was not visualized; however, local mucosal edema caused by irritation, collection of CSF in specific sinuses, or ethmoidal cells suggested the fistula's location. A meningocele protruding through the bone defect was detected in 10 patients: in 4, it was located in the lateral wall of the sphenoid sinus (always in the lateral recess); and in 6, it was located on the upper wall of the ethmoid sinus. [Medline]. Lieberman SM, Chen S, Jethanamest D, Casiano RR. Am J Rhinol 2003;17:91-6. Endoscopic closure has revolutionized the management of CSF rhinorrhea due to its less morbidity and better closure rate. Kevin C Welch, MD Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Northwestern University, The Feinberg School of Medicine Refine your search: Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea.  ME Endonasal endoscopic closure of cerebrospinal fluid fistulas at the anterior cranial base. Lumbar puncture was always performed in the operating room immediately before the beginning of surgery. 22(4):718-20. Bateman N, Mason J, Jones NS. Otolaryngol Head Neck Surg.  DCO'Brien ORL J Otorhinolaryngol Relat Spec 1999;61:131-2. Some cases require surgery, including repair to spontaneous leaks and most traumatic leaks involving skull base defects, which require repair of the bone and the meningeal tear. Submitted for publication October 1, 2002; accepted November 12, 2002. Ann Otol Rhinol Laryngol 2001;110:142-7. In 2002, Dunn et al12 reported that, in a series of 29 consecutive patients with CSF, rhinorrhea was spontaneous in 10. Setting 

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