Multilayered Endonasal endoscopic repair of CSF leaks of sphenoid sinus

Document Type : Original Article

Authors

1 Department of Otorhinolaryngology, Al-Azhar Faculty of Medicine New Damietta; Egypt.

2 Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt

3 Neurosurgery Department, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt.

Abstract

Cerebrospinal fluid rhinorrhea of the sphenoid sinus is a serious clinical condition. Endoscopic management has become the gold standard treatment. Use of multilayer closure to occlude the anatomical defect was suggested by some reports. The current study aims to evaluate endoscopic repair of sphenoid sinus CSF leak using multilayer closure. The present study included 17 patients. Their CSF leak was caused by accidental trauma in 9 patients (52.9 %), iatrogenic trauma in 1 patient (5.9 %) and in 7 patients (41.1 %), the leak occurred spontaneously. After localization of the leak, multilayer closure was used for anatomical defect repair. All patients achieved successful operative repair form the first attempt. The reported complications included meningitis in only 1 patient (5.9 %).Endoscopic repair of the sphenoid sinus CSF leaks using multilayer closure is a safe and effective approach. The Hadad–Bassagasteguy flap is the corner stone for sealing skull base defects in sphenoid sinus.

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