Endoscopic repair of cerebrospinal fluid leaks to the sinonasal tract: Predictors of success

Citation
Jl. Zweig et al., Endoscopic repair of cerebrospinal fluid leaks to the sinonasal tract: Predictors of success, OTO H N SUR, 123(3), 2000, pp. 195-201
Citations number
19
Categorie Soggetti
Otolaryngology
Journal title
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
ISSN journal
01945998 → ACNP
Volume
123
Issue
3
Year of publication
2000
Pages
195 - 201
Database
ISI
SICI code
0194-5998(200009)123:3<195:EROCFL>2.0.ZU;2-9
Abstract
INTRODUCTION: Cerebrospinal fluid (CSF) leaks may arise as a complication o f endoscopic sinus surgery, trauma, or hydrocephalus, or they may occur spo ntaneously without any identifiable cause. Despite general agreement that C SF leaks should not be left untreated, their initial management, the surgic al indications, and the technique of repair are controversial. OBJECTIVE: We undertook this study to ascertain whether a particular surgic al technique or material was more successful for repair. Additionally, we t ried to identify which specific characteristics of the patient, the CSF fis tula, or the adjunctive treatment influenced the result of the repair. STUDY DESIGN: We completed a retrospective review of all patients undergoin g endoscopic repair of a CSF leak at our academic hospitals. RESULTS: Forty-eight patients with 53 CSF fistulas were included in the stu dy. Fifty sites were successfully repaired endoscopically on the first atte mpt. Three persistent leaks were repaired successfully on the second attemp t. Location and size of the leak, cause, technique, and choice of material used for the repair did not significantly affect surgical outcome. However, the presence of hydrocephalus had a statistically significant negative inf luence on surgical outcome. All patients with increased intraventricular pr essure required a ventricular shunt in addition to a second endoscopic repa ir. CONCLUSION: if the surgical technique is sound, endoscopic repair of CSF le aks is highly successful, independent of the choice of the material and tec hnique used in the repair.