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Repair of cerebrospinal fluid rhinorrhoea with pedicled dural flap
Abstract:
Four cases of persistent cerebrospinal fluid rhinorrhoea through the ethmoid sinus are presented. Using the operative microscope, the margin of the dural defect was easily identified, and a pedicled dural flap supplied by branches of a meningeal artery was successfully sutured to the dural margin in a watertight fashion without increasing pre-existing neurological deficits. To prevent intracranial infection, the watertight closure with a predicled dural flap is presumably more complete and reasonable than are various grafts without vascular circulation.
Insights
This study presents a surgical technique for persistent cerebrospinal fluid (CSF) leaks through the ethmoid sinus. A pedicled dural flap provides watertight closure, preventing intracranial infection.
Area of Science:
- Neurosurgery
- Otolaryngology
Background:
- Persistent cerebrospinal fluid (CSF) rhinorrhoea poses a risk of meningitis.
- Ethmoid sinus defects are a common cause of CSF leaks.
Observation:
- Four cases of persistent CSF rhinorrhoea were treated.
- The operative microscope facilitated identification of the dural defect.
Findings:
- A pedicled dural flap, supplied by meningeal artery branches, was successfully used for repair.
- Watertight closure was achieved without worsening neurological deficits.
Implications:
- This technique offers a potentially more complete and reasonable method for preventing intracranial infection compared to grafts lacking vascular supply.
- Dural flap repair is a viable option for managing complex CSF leaks.