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Endonasal endoscopic repair of ethmoid roof cerebrospinal fluid fistula by suturing the dura

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Abstract

Introduction

Over the past 20years, improvement in surgical techniques as well advances in surgical instruments for sinus surgery has led to surgical closure of cerebrospinal fluid (CSF) leak using endoscopic approach. Minimally invasive and having lower post op morbidity, compared to traditional intracranial techniques, repairing CSF leak endoscopically has evolved to become the standard practice for management of CSF leak.

Discussion

Widespread use of endoscope in sinus surgery have made us more familiar with the anatomy of the sinuses as well as the skull base. In this paper, we will describe our experience of CSF repair by suturing dura under endoscopic guidance for the repair of small ethmoid roof (<1.2cm) defects.

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Author information

Authors and Affiliations

  1. Department of ENT, Tepecik Medical Training Hospital, Izmir, Turkey

    İbrahim Cukurova, İlker Burak Aslan & Dogan Ozkul

  2. Department of ENT, Ataturk Government Hospital, Antalya, Turkey

    Erdem Atalay Cetinkaya

Authors
  1. İbrahim Cukurova
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  2. Erdem Atalay Cetinkaya
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  3. İlker Burak Aslan
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  4. Dogan Ozkul
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Corresponding author

Correspondence to Erdem Atalay Cetinkaya.

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Comment

This paper presents a different story and there has not been too much in Acta about this subject lately.  At first I thought it might be too   different for neurosurgeons, even to be dangerous, in  that another speciality might  take a part of our work. Even if we have whole the transsphenoidal surgery I am not sure if it always meets the needs of surgical methods in neurotraumatology. The authors are otologists, they do not see the whole problem of brain injury, and they do not often see the serious injuries with early frontal leaks. Nevertheles, it is clearly important to do as much as possible with the endoscope extracranially, when it is reasonable, I am not sure how often the dura looks nice and easy to suture, but not even that is important, if a less traumatic procedure is possible. Working together would be a useful learning experience.

M. Vapalahti

Kuopio University Hospital, Finland

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Cukurova, İ., Cetinkaya, E.A., Aslan, İ.B. et al. Endonasal endoscopic repair of ethmoid roof cerebrospinal fluid fistula by suturing the dura. Acta Neurochir (Wien) 150, 897–900 (2008). https://doi.org/10.1007/s00701-008-0005-7

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  • DOI: https://doi.org/10.1007/s00701-008-0005-7

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