Cerebrospinal fluid leakage after endonasal dacryocystorhinostomy.
J Fr Ophtalmol
; 30(2): 129-34, 2007 Feb.
Article
en En
| MEDLINE
| ID: mdl-17318093
An endonasal dacryocystorhinostomy (DCR) was followed by cerebrospinal fluid leakage and pneumoencephalocele in an 80-year-old female patient presenting four independent risk factors for an ethmoidal breach: severe septal deviation requiring forced reclining, a cranial insertion of the perpendicular plate of the ethmoid directly onto the cribriform plate, meningeal prolapse, and extensive osteoporosis of the skull base. The use of a Killian valve speculum to recline the nasal septum was probably the main cause of the anterior skull base fracture. The defect was repaired by a composite patch of septal cartilage, abdominal fat grafts, Surgicel, and inferior turbinate mucosa. Thirty-four months after surgery, there was no residual symptom. A narrow nasal fossa makes endoscopic DCR more difficult to perform. The use of a Killian valve speculum to enlarge the nasal fossa may carry a risk for structural damage to the skull base. A narrow nasal fossa may require an external DCR or a prior endoscopic septoplasty to facilitate an endonasal approach. Closing an ethmoidal defect causing cerebrospinal fluid leakage can be successfully achieved by an endonasal approach rather than by a more conventional neurosurgical method.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dacriocistorrinostomía
/
Rinorrea de Líquido Cefalorraquídeo
/
Aparato Lagrimal
/
Mucocele
Tipo de estudio:
Risk_factors_studies
Límite:
Aged80
/
Female
/
Humans
Idioma:
En
Revista:
J Fr Ophtalmol
Año:
2007
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Francia