Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus

BACKGROUND: Cerebrospinal (CSF) fluid leaks with associated pneumocephalus (PNC) represent a condition bearing serious risks for the patient, with little data available in the literature. Reported success rates of endoscopic skull base repair are lower when PNC is associated than in the case of simple CSF leaks. The present study represents an analysis of our experience with endoscopic management of this condition.

METHODS: Records of patients with pneumocephalus and associated CSF leaks, who underwent endoscopic skull base repair, were reviewed. Demographics, history, etiology of PNC, size of defect, surgical approach, reconstruction technique and complications were evaluated.

RESULTS: Twenty patients with CSF leaks and PNC underwent endonasal repair by the senior author between 2005 and 2019. Defect size was larger than 15 mm in all cases. All patients presented either worsening of PNC under conservative treatment or tension PNC. First-attempt closure of the defect was successful in all patients (100%), with resolution of the pneumocephalus. One patient developed a synechia in the proximity of the frontal ostium, as a postoperative complication. The mean follow-up was 39 months (range: 15-94 months).

CONCLUSION: The present study represents a proposed argument for earlier endoscopic endonasal treatment in patients presenting CSF leaks and pneumocephalus.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

Journal of clinical medicine - 10(2020), 1 vom: 25. Dez.

Sprache:

Englisch

Beteiligte Personen:

Gâta, Anda [VerfasserIn]
Toader, Corneliu [VerfasserIn]
Trombitaș, Veronica Elena [VerfasserIn]
Ilyes, Annamaria [VerfasserIn]
Albu, Silviu [VerfasserIn]

Links:

Volltext

Themen:

CSF leak
Cranialization
Endoscopic repair
Journal Article
Pneumocephalus
Skull base

Anmerkungen:

Date Revised 12.01.2021

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/jcm10010046

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM319398137