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[Dura-plasty in the area lf the sphenoid sinus]
1Klinik für HNO-Krankheiten, Kopf-, Hals-und Plastische Gesichtschirurgie, Kommunikationsstörungen, Städtisches Klinikum Fulda.
Background:
Surgical treatment of CSF leakage in the sphenoid sinus is difficult for several reasons: 1. the close neighbourhood between the sphenoid sinus and the internal carotid artery, the cavernous sinus and cranial nerves (II, III, IV, VI), 2. a strong liquorrhoea caused by basal cisterns surrounding the sphenoid sinus, 3. it can be difficult to visualise completely the sphenoid sinus depending on the extent of pneumatisation.
Materials And Methods:
In this retrospective study 20 cases of duraplasty around the sphenoid sinus were evaluated. The approach, materials, operative techniques and results are described.
Results:
90% of the dura lesions were closed successfully by one operation (average follow-up time 5 years). Including our two revisions all defects have been sealed effectively.
Conclusions:
Currently, the endonasal approach using microscope and endoscope is the technique of choice for dura repair in the sphenoid sinus. The different techniques and materials vary in order of size, location and etiology of the dura lesion.