Abstract
Cerebrospinal fluid (CSF) rhinorrhea can lead to CNS infections, carrying significant morbidity and mortality, especially in the elderly. Endoscopic endonasal surgery is a validated technique in the repair of anterior skull base CSF leaks. The aim of this study is to assess diagnostic management, surgical technique and clinical outcome in a consecutive series of elderly patients. Patients older than 65 years treated for anterior skull base CSF leaks through endoscopic endonasal surgery between 2003 and 2014 were retrospectively reviewed. All patients underwent preoperative nasal endoscopy, laboratory and radiological assessment. In doubtful cases endoscopic exploration was performed after intrathecal fluorescein (IF) injection. Patients were discharged between 3 and 4 days after surgery, and the endoscopic follow-up ranged from 3 to 24 months. 20 patients (age range 65-92) presented with 10 spontaneous and 10 traumatic/iatrogenic CSF leaks. In 40% of patients formal rhinoscopy and radiological assessment did not localize the CSF leak and IF injection was performed. IF enabled the identification of the skull base defect in all cases, with no adverse effects. In 11 cases the dura was repaired with fascia lata graft. All patients ...Continue Reading
References
Jan 1, 1990·Acta neurochirurgica·C Probst
Aug 1, 1990·The Laryngoscope·D E Mattox, D W Kennedy
Dec 1, 1994·Drugs & Aging·G ZuccalàP Carbonin
Aug 30, 2000·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·J L ZweigH Hegazy
Jul 19, 2001·Neurologia Medico-chirurgica·M F OzverenK Uchida
Aug 22, 2002·Neurosurgery·Enrico de DivitiisLuigi Maria Cavallo
Oct 12, 2004·Arquivos de neuro-psiquiatria·José Alberto LandeiroMaria Helena Melo
Jan 25, 2006·Minimally Invasive Neurosurgery : MIN·F TosunM Gerek
Apr 4, 2006·Neurosurgery·Davide LocatelliPaolo Castelnuovo
May 19, 2006·Minimally Invasive Neurosurgery : MIN·L R F SilvaS T Zymberg
Aug 2, 2007·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Abtin TabaeeVijay K Anand
Jun 27, 2008·Neurosurgery·Theodore H SchwartzVijay K Anand
May 7, 2009·The Laryngoscope·Rupali N ShahAdam M Zanation
Jul 18, 2009·Surgical Neurology·Hai-sheng LiuHuan-cong Zuo
Aug 28, 2010·Clinical Radiology·S E J Connor
Oct 5, 2010·American Journal of Otolaryngology·Vinni MakinBurak Sade
Nov 26, 2010·International Journal of Pediatric Otorhinolaryngology·Jagveer Singh YadavAbhilash Alex Francis
Aug 16, 2013·Acta Oto-laryngologica·Clement SchoentgenFranck Jegoux
Citations
Jan 18, 2018·Head & Neck·Davide LeperaPaolo Castelnuovo
Nov 3, 2017·Laryngoscope Investigative Otolaryngology·Brian C LoboRick F Nelson
Jul 19, 2017·The Journal of Laryngology and Otology·G M OakleyR J Harvey
Apr 25, 2020·World Neurosurgery·Arash AbiriEdward C Kuan
Jan 1, 2021·Seminars in Plastic Surgery·Weitao WangYadranko Ducic
Oct 13, 2021·World Neurosurgery·Giuseppe E UmanaValentino Valentini