Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Road, 813 Kaohsiung, Taiwan, Republic of China.
Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Nov;138 Suppl 4:135-136. doi: 10.1016/j.anorl.2021.06.010. Epub 2021 Jul 8.
Cerebrospinal fluid (CSF) leak and encephalocele from the middle cranial fossa into the sphenoid sinus lateral recess (SSLR) is a rare condition. It is often associated with obesity, female sex, well-pneumatized sinus, and prolonged intracranial hypertension. Endoscopic repair has emerged as the mainstay treatment with a success rate increasing to over 90% by refining reconstruction methods and controlling intracranial pressure. Here, we describe how a female with SSLR CSF leak and encephalocele successfully managed with endoscopic transpterygoid approach and multilayered repair. The defect was closed using four indifferent tissues, including the duragen patch, sinus mucosal flaps, the middle turbinate bone, and free mucosa flap, from the inside out. The patient had an uneventful postsurgical course and remained disease-free during the 9-month follow-up. To conclude, the technique of using sinus mucosal flaps in the context of multilayered reconstruction might be a useful method to repair CSF leak.
脑脊液（CSF）漏和从中颅窝经蝶窦外侧隐窝（SSLR）进入蝶窦的脑膨出是一种罕见的情况。它通常与肥胖、女性、鼻窦充气良好和长期颅内压升高有关。内镜修复已成为主要的治疗方法，通过改进重建方法和控制颅内压，成功率增加到 90%以上。在这里，我们描述了一位女性患者如何通过经翼突内镜入路和多层修复成功治疗 SSLR CSF 漏和脑膨出。该缺陷采用从内到外的四种不同组织（包括 duragen 补丁、鼻窦黏膜瓣、中鼻甲骨和游离黏膜瓣）进行封闭。患者术后无并发症，9 个月的随访期间无疾病复发。总之，在多层重建的背景下使用鼻窦黏膜瓣的技术可能是修复 CSF 漏的一种有用方法。
