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Endonasal Endoscopic Repair of Sternberg's Canal Cerebrospinal Fluid Leaks
Author(s) -
Castelnuovo Paolo,
Dallan Iacopo,
Pistochini Andrea,
Battaglia Paolo,
Locatelli Davide,
Bignami Maurizio
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000251452.90657.3a
Subject(s) - medicine , cerebrospinal fluid leak , cerebrospinal fluid , surgery , sinus (botany) , sphenoidal sinus , skull , leak , endoscopic endonasal surgery , retrospective cohort study , lateral recess , paranasal sinuses , lumbar , botany , pathology , environmental engineering , engineering , biology , genus
Objectives: Management of cerebrospinal fluid leaks or encephaloceles of Sternberg's canal is challenging. Transnasal visualization of this area is difficult, especially when large pneumatization is present. External approaches to this region involve aggressive surgery and are often associated with significant morbidity. The aim of the study was to assess the real effectiveness of an endoscopic endonasal approach for treating cerebrospinal fluid leaks of the lateral recess of the sphenoid sinus. Study Design: The authors conducted a retrospective evaluation. Methods: Clinical charts of patients with cerebrospinal fluid leaks and/or encephaloceles of Sternberg's canal treated at our institution were retrospectively reviewed. All these patients were managed with an endonasal endoscopic procedure. Results: Fifteen patients (9 female and 6 male) were included in this study. Nine patients underwent a transethmoidal–pterygoidal–sphenoidal approach with a multilayer reconstructive technique. No cerebrospinal fluid leak recurrences were observed during follow up (mean follow up 37.6 ± 21.7 standard deviation months) Conclusions: The transethmoidal–pterygoidal–sphenoidal approach provides a wide, safe, and direct route to the lateral recess of the sphenoid sinus. Multilayered reconstruction of the skull base defects must be considered the first option for this kind of lesion.