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Trans-frontal extracranial approach in repair of cerebrospinal fluid fistula
O A Lasisi1, B M Ahmad, O A Ogunbiyi
1Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria. sakeemng@yahoo.com
Insights
A cerebrospinal fluid (CSF) fistula was successfully repaired using a minimally invasive external approach. This technique offers reduced morbidity and mortality for patients with traumatic CSF leaks.
Area of Science:
- Neurosurgery
- Otolaryngology
- Trauma Surgery
Background:
- Cerebrospinal fluid (CSF) fistulas can result from head trauma.
- Traditional surgical repair methods may involve significant intracranial approaches.
Observation:
- A 35-year-old woman with a 2-year history of unilateral rhinorrhea presented after a childhood head injury.
- Clinical and radiological evaluation confirmed a CSF fistula involving the frontal sinus and ethmoid.
Findings:
- Successful surgical repair of the CSF fistula was achieved using a deep temporalis fascial graft.
- An external transfrontal approach was utilized, avoiding intracranial intervention.
Implications:
- Minimally invasive external techniques are effective for treating CSF fistulas.
- This approach reduces patient morbidity and mortality compared to traditional methods.
- Highlights the shift towards less invasive surgical strategies in managing traumatic CSF leaks.
Abstract:
A 35 year old African woman presented with a 2 year history of unilateral watery left anterior rhinorrhoea, the only other significant feature being a history of severe head injury during childhood. Clinical and radiological evaluation confirmed a cerebrospinal fluid fistula, localized in the inferior portion of the posterior wall of the frontal sinus and ethmoid, no intracranial pathology. Repair was done successfully with a deep temporalis fascial graft through an external transfrontal approach. We report this to buttress the current trend in which less invasive external and endoscopic techniques are replacing intracranial methods. Reduction in morbidity and mortality which are the merits of this technique are emphasized and the management is discussed.
