[Endoscopic transnasal approach for repairing anterior skull base cerebrospinal fluid rhinorrhea and meningoencephalocele: preliminary experience of using fat bath-plug technique].

OBJECTIVE

To summary the preliminary experience of fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base cerebrospinal fluid rhinorrhea (CSF) and meningoencephalocele.

METHOD

Using fat bath-plug technique repair 1 case meningoencephalocele (traumatic) and 5 cases cerebrospinal fluid rhinorrhea (1 traumatic, 4 spontaneous). The analysis index included: preoperative localization, intraoperative position, surgical procedures, perioperative symptoms, follow-up. etc.

RESULT

CT and MRI techniques were used for location of the fistula preoperative. The location of the fistulas were exploration during the operation and were consist with the imaging studies. All 6 fistulas were repaired during the first operation. No fever and no intracranial infection occurred postoperatively. All the patients discharged 7 days postoperatively with an iodoform nasal packing. Three to 4 weeks later the patients were reviewed to clean up the nasal cavity. All patients were recovered well with good epithelial mucosa in the 3 and 6 months endoscopic follow-ups. No CSF leak and intracranial infection happened in the 3-year telephone follow-up.

CONCLUSION

The fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base small fistula, especially in cribriform ethmoid roof, is effective, safe and simple.