EXPERIENCE OF ENDOSCOPIC REPAIR OF CEREBROSPINAL FLUID RHINORRHEA

Abstract

Objective: To make an estimate of magnitude of cerebrospinal fluid rhinorrhea patients presenting in Otorhinolaryngology department of CMH Lahore and further elaboration of our experience of different techniques of endonasal endoscopic repair of cerebrospinal fluid leak.

Study Design: Cross-sectional analytical study. Place and Duration of Study: Combined Military Hospital Lahore, from Jan 2017 to Dec 2017.

Methodology: For this analytical study last one year’s data of cerebrospinal fluid rhinorrhea patients as well as all endoscopic surgeries was collected retrospectively from ENT department registers. Both male and female patients of all ages undergoing functional endoscopic sinus surgery were included in study to calculate the magnitude of cerebrospinal fluid rhinorrhea.

Results: During the last one year, 832 ENT surgeries were performed out of which 234 (28%) were functional endoscopic sinus surgeries. Total 10 cerebrospinal fluid rhinorrhea patients presented in ENT department of CMH Lahore in the last one year and all these underwent endonasal endoscopic repair surgery in operation theatre. Out of these 3 were males and 7 females. Age range was 43 to 67 years (average age was 53.2 years). Out of 10 cases of cerebrospinal fluid rhinorrhea treated endoscopically, 4 (40%) were iatrogenic, 3 (30%) were traumatic and 3 (30%) had spontaneous cerebrospinal fluid leakage.

Conclusion: Cerebrospinal fluid leakage is quite rare happening and its surgical management is also difficult to master. In our study use of facialata (alone or with septal cartilage) to endoscopically repair the leak has proved to be successful in 90% of cases.