Endoscopic repair of cerebrospinal fluid fistulas in nasal liquorrhea

Publication date: Available online 4 June 2016
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Vladimir Kljajić, Petar Vuleković, Ljiljana Vlaški, Slobodan Savović, Danijela Dragičević, Vladimir Papić
IntroductionNasal liquorrhea indicates a cerebrospinal fluid fistula, an open communication between the intracranial cerebrospinal fluid and the nasal cavity. It can be traumatic and spontaneous.ObjectiveThe aim of this study was to assess the outcome of endoscopic repair of cerebrospinal fluid fistula using fluorescein.MethodsThis retrospective study included 30 patients of both sexes, with a mean age of 48.7 years, treated in the period from 2007 to 2015. All patients underwent lumbar administration of 5% sodium fluorescein solution preoperatively. Fistula was closed using three-layer graft and fibrin glue.ResultsCerebrospinal fluid fistulas were commonly located in the ethmoid (37%) and sphenoid sinus (33%). Most patients presented with traumatic cerebrospinal fluid fistulas (2/3 of patients). The reported success rate for first attempt repair was 97%. Complications occurred in three patients: one patient presented with acute hydrocephalus, one with reversible encephalopathy syndrome on the fifth postoperative day with bilateral loss of vision, and one patient was diagnosed with hydrocephalus two years after the repair of CSF fistula.ConclusionEndoscopic diagnosis and repair of cerebrospinal fluid fistulas using fluorescein intrathecally has high success rate and low complication rate.



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