You searched for "CSF"

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Transnasal endoscopic repair of CSF leaks

This Italian study was a retrospective review of 110 consecutive patients who underwent repair of their CSF leak via the transnasal endoscopic approach from 2003 to 2013. All surgery was performed by the same primary surgeon and patients with a...

CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Patient factors associated with spontaneous CSF leak

This article highlights the role of obesity, sleep apnoea and raised intracranial pressure as linked pathologies in the aetiology of the spontaneous cerebrospinal fluid (sCSF) leak. The authors link sCSF leak with obesity and comment on sCSF leak incidence increasing...

Multi-layered repair of lateral sphenoid CSF rhinorrhoea

This case series describes the author’s results with repairing lateral sphenoid encephalocoeles in seven patients. Alloderm inlay with abdominal fat onlay and nasoseptal flap onlay repair resulted in a 100% success rate with no recurrence of cerebrospinal fluid (CSF) rhinorrhoea,...

Endoscopic CSF leak repair using nasoseptal flap

Many of us during training or in established practice will have encountered the complication of anterior skull base CSF leak. This can be a challenging problem to deal with and in this article the authors describe their favoured approach. Cerebrospinal...

A new hydrogel dural sealant for CSF repair

This paper reports the findings of a multicentre prospective randomised trial conducted to demonstrate the efficacy of the Adherus Dural Sealant for FDA approval. The Adherus Dural Sealant was compared with the control, DuraSeal Dural Sealant. It was applied to...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...

Comprehensive Techniques in CSF leak repair and skull base reconstruction

This book certainly does what it says on the tin, and covers its subject very comprehensively. Normally a topic covered by a single chapter in a rhinology or skull base surgery textbook, this book offers 17 chapters on all aspects...

Predicting CSF leaks pre FESS: Gera classification - a new tool?

An interesting study from Italy looking at an anterior skull base classification that may be useful in predicting risk of intraoperative CSF leak during FESS surgery. Traditionally we have used the Keros classification system, developed in 1962 to categorise olfactory...

Managing spontaneous CSF leaks secondary to benign intracranial hypertension

Spontaneous CSF leaks are a rare entity. In this paper, a Spanish group report their experience managing the condition using endoscopic surgery in 35 patients over an eight year period. Leak locations included the cribriform plate (18/35), ethmoid roof (15/35)...

Do endonasal approaches for meningiomas have more CSF leaks?

Rarely, patients presenting to the ENT surgeon with anosmia may have an anterior skull base neoplasm such as a meningioma. Historically, the traditional approaches have focused on several transcranial, external routes, including the pterional craniotomy, and the subfrontal craniotomy. The...

Outpatient closure of CSF leaks: a good idea or a step too far?

After day-case septoplasty, day case thyroidectomy, now day case CSF leak repair – has the pendulum moved too far? The authors put forward a convincing case for what, only 10 years ago, would have sounded like a provocation. They quote...