Endoscopic repair of cerebrospinal fluid leaks in the lateral sphenoid sinus recess: Clinical article

Boaz Forer, Dharmbir S. Sethi

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Object. Cerebrospinal fluid leaks may occur as a result of trauma or following surgery, and occasionally may also be spontaneous. Leakage of CSF from the lateral sphenoid recess is rare and challenging to treat. The authors present their experience with repairs of 10 CSF leaks that were confined to the lateral sphenoid recess and were treated at the Singapore General Hospital. Methods. A retrospective chart review was conducted for all patients who underwent operations for lateral sphenoid recess CSF leaks between 2001 and 2008. Results. Ten repairs were performed in 8 patients by using a transpterygoid approach, with a 90% success rate. In 3 cases the transcranial approach had failed prior to endoscopic repair. "Sandwich reconstruction" under direct vision was performed in all cases, and was completed using cartilage or bone as a rigid support. Conclusions. This series demonstrates that CSF leakage can be managed safely and effectively by using an endoscopic transpterygoid approach in patients in whom both external and endoscopic attempts have failed. The transpterygoid approach used in all of the cases in this series provides wide exposure around the skull base defect, which is crucial for successful repair.

Original languageEnglish
Pages (from-to)444-448
Number of pages5
JournalJournal of Neurosurgery
Volume112
Issue number2
DOIs
StatePublished - 1 Feb 2010
Externally publishedYes

Keywords

  • Cerebrospinal fluid
  • Cerebrospinal fluid leak repair
  • Endoscopic transpterygoid approach
  • Lateral sphenoid recess

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