RESULTS OF ENDOSCOPIC ENDONASAL CSF RHINORRHEA REPAIR: RETROSPECTIVE EVALUATION
1Adnan Menderes Üniversitesi, Kulak Burun Boğaz Anabilim Dalı, Aydin, Türkiye Objective: Cerebrospinal fluid (CSF) rhinorrhoea is the fistulization of cerebrospinal fluid into the nasal cavity or paranasal sinuses due to anterior skull base defect. Treatment of CSF rhinorrhea that does not respond to conservative treatment should be surgical. The aim of our study is to investigate the results of CSF rhinorrhea cases that we repaired with the transnasal endoscopic approach and to examine the factors that may affect the success of this surgery.Materials And Methods: Patients with CSF rhinorrhea treated with transnasal endoscopic approach at Aydın Adnan Menderes University ENT Department between January 2014 and August 2021 were retrospectively screened. Patients who had postoperative control and follow-up and sufficient data in their files, was included in the study. Patient files were reviewed, and post-operative cessation of rhinorrhea was considered success, otherwise failure.
Results: In the retrospective examination, 25 patients with sufficient data in their files were detected. Among these patients, 3 patients with a bone defect in the frontal sinus were excluded from the study because they were converted to open surgery due to the location and size of the defect. The mean skull base defect dimensions were 6.68 mm (±4.4 mm). The location of these defects; 10 were in the cribrifoma plate, 5 were in the fovea ethmoidalis, 5 were in the sphenoid sinus, and 1 was in the frontal sinus. One patient had fovea ethmoidalis defect with cribriform plate. Various grafts, at least two layers, were used in all patients to repair the defect. Our mean postoperative follow-up period was 3 years (±2 years). In the postoperative follow-up, it was observed that the CSF fistula recurred in 2 patients. With these results, the success rate of endoscopic surgery was found to be 90%.
Conclusion: As long as the appropriate procedure is followed in CSF rhinorrhea repair; has been considered graft selection, size and localization of the defect do not significantly affect the success rate. More precise results can be obtained with prospective studies that include more cases and make specific comparisons.
Keywords : CSF, Rhinorrhea, Endoscopic