Sinus anatomy associated with inadvertent cerebrospinal fluid leak during functional endoscopic sinus surgery

The Laryngoscope
Chase M HeatonC M Glastonbury

Abstract

Anatomic variations in skull base anatomy may predispose the surgeon to inadvertent skull base injury with resultant cerebrospinal fluid (CSF) leak during functional endoscopic sinus surgery (ESS). Our objective was to compare preoperative sinus imaging of patients who underwent FESS with and without CSF leak to elucidate these variations. In this retrospective case-control study, 18 patients with CSF leak following FESS for chronic rhinosinusitis (CRS) from 2000 to 2011 were compared to 18 randomly selected patients who underwent preoperative imaging for FESS for CRS. Measurements were obtained from preoperative computed tomography images with specific attention to anatomic differences in cribriform plate and ethmoid roof heights in the coronal plane, and the skull base angle in the sagittal plane. Mean values of measured variables were compared using a nonparametric Mann-Whitney test. When compared to controls, patients with CSF leak demonstrated a greater angle of the skull base in the sagittal plane (P < .001) and a greater slope of the skull base in the coronal plane (P < .006). A lower cribriform height relative to ethmoid roof height was also noted in cases of CSF leak as compared to controls (P < .04). A steep skull bas...Continue Reading

References

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Citations

Oct 18, 2015·Neuroimaging Clinics of North America·Steve E J Connor
Apr 28, 2017·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Muaid I Aziz BabanPaolo Castelnuovo
Mar 2, 2021·Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India·Satish Nair, Ameena Ibrahim
Nov 26, 2020·International Forum of Allergy & Rhinology·Richard R OrlandiBing Zhou
May 28, 2021·American Journal of Rhinology & Allergy·Gian Luca FaddaGiovanni Cavallo

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