The 'Parachute' technique for the endoscopic repair of high-flow anterior skull-base CSF leaks

xlomafota13 shared this article with you from Inoreader The "Parachute" technique for the endoscopic repair of high-flow anterior skull-base CSF leaks Via leak of cerebrospinal fluid World Neurosurg. 2021 May 8:S1878-8750(21)00689-6. doi: 10.1016/j.wneu.2021.05.006. Online ahead of print. ABSTRACT OBJECTIVE: This study aims to assess the feasibility and reliability of our endoscopic trans-nasal technique for the repair of cribriform and sellar high-flow CSF leaks. METHODS: A comparison between patients suffering from high-flow rhinorrhea and treated through a free grafting endoscopic technique or the "parachute" technique, our nasal packing proposal, was performed. RESULTS: Thirty-three patients were included. The mean age was 52 years (range 36-68). The etiology of the CSF leaks was iatrogenic in 16 cases (48,5%), traumatic in 5 cases (15,2%), spontaneous in 11 cases (33,3%) and related to anterior skull base tumors in one case (3%). The bone defect affected the sphenoidal sinus in 20 cases (60,6%), the cribriform plate of the ethmoid in 10 cases (30,3%), and both the sphenoid and ethmoid in 3 cases (9,1%). T he mean size of bone defects was 8,5 ± 3,9 mm. The median follow-up was 28 (64) months. A CSF leak recurrence occurred in no cases treated with the "parachute" technique and in three cases that underwent conventional endoscopic treatments. The CSF leak recurrences were associated with two iatrogenic and one post-traumatic fistula. All the CSF leak recurrences underwent the parachute technique, not showing second recurrences. CONCLUSION: Our results suggest that the "parachute" technique is simple, safe and effective. We recommend it as an alternative treatment to vascular flaps for the treatment of high-flow and recurrent fistulas. PMID:33974988 | DOI:10.1016/j.wneu.2021.05.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.