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Endonasal endoscopic management of spontaneous cerebrospinal fluid rhinorrhoea: The Birmingham UK experience.
Jolly, Karan; Gupta, Keshav Kumar; Bhamra, Navdeep; Aslanidou, Anastasia; Batra, Ruchika; Ahmed, Shahzada K.
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  • Jolly K; Department of Otolaryngology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Gupta KK; Department of Otolaryngology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Bhamra N; Department of Otolaryngology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Aslanidou A; Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Batra R; Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Ahmed SK; Department of Otolaryngology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Asian J Endosc Surg ; 16(1): 68-76, 2023 Jan.
Article en En | MEDLINE | ID: mdl-36116916
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks (SCSFL) occur in the absence of trauma, surgery, or underlying intracranial pathology. They represent a significant healthcare burden on patients with complications such as meningitis. We present our experience of SCSFL repair via the endonasal endoscopic approach. METHODS: All patients who underwent CSF fistula repair at a tertiary UK hospital, between 1st January 2012 to 31st December 2019, were identified and had their case notes analyzed retrospectively. RESULTS: There were 33 patients included consisting of 27 (81.8%) females, with age range from 31 to 81 years (mean 55.2). Mean body mass index (BMI) was 35.2 kg/m2 , with 32 (97.0%) patients overweight (BMI >25). All patients presented with intermittent watery rhinorrhoea and had a positive biochemical analysis. Computed tomography (CT) and/or magnetic resonance imaging (MRI) identified leak sites in 29 patients (87.9%). The most common intraoperative defect site was the cribriform plate (42.4%). A variety of closing techniques were used including onlay grafts (72.7%), tissue glue (87.9%), nasoseptal flaps (63.6%), mucosal free grafts (21.2%), fat grafts (21.2%), and additional support materials (87.9%). Nasal packing was used in all patients. The average length of stay was 1.6 days. Postoperative complications occurred in two patients (6.1%) (meningitis, epistaxis). Overall, there was a successful primary repair in 32 (97.0%) patients with most cases employing a multilayered reconstruction method (78.8%). CONCLUSION: Our results demonstrate excellent success rates with the endoscopic endonasal approach to SCSFL. This adds to the literature by demonstrating a detailed analysis of the experience in SCSFL management in one of the largest UK centres.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rinorrea de Líquido Cefalorraquídeo / Meningitis Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Asian J Endosc Surg Año: 2023 Tipo del documento: Article Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Rinorrea de Líquido Cefalorraquídeo / Meningitis Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Asian J Endosc Surg Año: 2023 Tipo del documento: Article Pais de publicación: Japón