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 simp...
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doaj-97feb597e1ba4b8eb9df77ab70d301b92020-12-26T00:02:29ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-0110464610.3390/jcm10010046Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with PneumocephalusAnda Gâta0Corneliu Toader1Veronica Elena Trombitaș2Annamaria Ilyes3Silviu Albu4Department of Otorhinolaryngology, University of Medicine and Pharmacy ‘Iuliu Hațieganu’, 400349 Cluj-Napoca, RomaniaClinic of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 41914 Bucharest, RomaniaDepartment of Otorhinolaryngology, University of Medicine and Pharmacy ‘Iuliu Hațieganu’, 400349 Cluj-Napoca, RomaniaDepartment of Radiology, Clinical Recovery Hospital, 400066 Cluj-Napoca, RomaniaDepartment of Otorhinolaryngology, University of Medicine and Pharmacy ‘Iuliu Hațieganu’, 400349 Cluj-Napoca, RomaniaBackground: 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.https://www.mdpi.com/2077-0383/10/1/46pneumocephalusskull baseendoscopic repairCSF leakcranialization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anda Gâta Corneliu Toader Veronica Elena Trombitaș Annamaria Ilyes Silviu Albu |
spellingShingle |
Anda Gâta Corneliu Toader Veronica Elena Trombitaș Annamaria Ilyes Silviu Albu Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus Journal of Clinical Medicine pneumocephalus skull base endoscopic repair CSF leak cranialization |
author_facet |
Anda Gâta Corneliu Toader Veronica Elena Trombitaș Annamaria Ilyes Silviu Albu |
author_sort |
Anda Gâta |
title |
Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus |
title_short |
Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus |
title_full |
Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus |
title_fullStr |
Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus |
title_full_unstemmed |
Endoscopic Skull Base Repair Strategy for CSF Leaks Associated with Pneumocephalus |
title_sort |
endoscopic skull base repair strategy for csf leaks associated with pneumocephalus |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-12-01 |
description |
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. |
topic |
pneumocephalus skull base endoscopic repair CSF leak cranialization |
url |
https://www.mdpi.com/2077-0383/10/1/46 |
work_keys_str_mv |
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