N. Venkatram Reddy1, K. Anjani kumari2, J. Bhupender Singh Rathod3, B. Vyshnavi4, K. Sushma Reddy5, P. Amreetha Kaur6
INTRODUCTION
CSF rhinorrhoea is the leakage of clear watery fluid from the subarachnoid space into nasal and/or sinus cavities. CSF leak is a known potential complication with significant morbidity and mortality. It may present a significant challenge in the diagnosis of localization of the site of the leak and its surgical management. CSF rhinorrhoea can be diagnosed with more accurate localization of the site of CSF leak with modern radiological methods. Repair involves surgical intervention, which has changed from open craniotomy to minimally invasive trans nasal endoscopic (TNE) surgical technique. Endoscopic repair(ER) through the nasal approach has gained popularity for the past two decades and practiced by ENT surgeons with or without the help of neurosurgeons.
AIM OF THE STUDY
1. To evaluate the causes and identification of CSF leak.
2. To assess the success rate in the CSF rhinorrhoea adopting a particular surgical technique and graft material by trans nasal endoscopic approach to skull base.
MATERIAL AND METHODS
This is a retrospective study of 76 established cases of CSF Rhinorrhoea (R) admitted and treated at Government ENT Hospital/Osmania Medical College, Hyderabad, Telangana State between 2005-2013.
INCLUSION CRITERIA
All the cases of CSF leak continuous or intermittent lasting for more than two weeks duration, irrespective of the aetiology.
The study cases include spontaneous, traumatic, meningoencephalocoeles, post functional endoscopic sinus surgery (FESS).
EXCLUSION CRITERIA
CSF leaks of less than two weeks duration (medical treatment).
CSF leaks with space occupying lesions in the brain.
CSF leaks with polytrauma (PT) and patient in emergency status.
RESULTS
CSF rhinorrhoea cases are evaluated with regard to their site of leak and trans nasal endoscopic (TNE) surgical approach and the results are drawn and success rate is compared with other studies in the literature.
CONCLUSION
The authors concluded that trans nasal endoscopic management of CSF Rhinorrhoea had high success rate, low morbidity and stable long term results.
