Article
Clinical Neurology
Alex P. Michael, Osama Elbuluk, Apostolos John Tsiouris, Abtin Tabaee, Ashutosh Kacker, Vijay K. Anand, Theodore H. Schwartz
Summary: The use of vascularized flaps in endonasal repair can significantly reduce the recurrence rate of spontaneous CSF leaks; Patients with higher BMI, larger brain herniations, and no CSF diversion are more likely to experience recurrence.
JOURNAL OF NEUROSURGERY
(2021)
Article
Medicine, General & Internal
Byung Kil Kim, Doo-Sik Kong, Do-Hyun Nam, Sang Duk Hong
Summary: This study compared different types of grafts for repairing high-flow cerebrospinal fluid leaks and found that acellular dermal matrix and banked homologous fascia lata grafts were non-inferior to autologous fascia lata grafts.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Neurosciences
Rakshith Srinivasa, C. Chandrakiran, Rini Luckose
Summary: This article describes a new technique for skull base repair using bilateral posterior nasoseptal flaps, which was successfully applied in endoscopic surgery of a 40-year-old female patient with no postoperative CSF leak.
Article
Clinical Neurology
Cathal John Hannan, Bharti Kewlani, Steven Browne, Mohsen Javadpour
Summary: This study reviewed a large series of endoscopic skull base cases and found that the adoption of a standardized multi-layer repair technique significantly reduced the post-operative CSF leak rate, without the use of nasal packing or lumbar drains.
ACTA NEUROCHIRURGICA
(2023)
Article
Medicine, General & Internal
Anda Gata, Corneliu Toader, Veronica Elena Trombitas, Annamaria Ilyes, Silviu Albu
Summary: This study analyzed successful closure of defects in 20 patients with pneumocephalus and CSF leaks through endoscopic skull base repair. The study suggests early endoscopic endonasal treatment for patients with CSF leaks and pneumocephalus.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Otorhinolaryngology
Woori Park, Do-Hyun Nam, Doo-Sik Kong, Kyung Eun Lee, Song Park, Hyo Yeol Kim, Seung-Kyu Chung, Yong Gi Jung, Sang Duk Hong
Summary: This study aimed to analyze the risk factors for postoperative CSF leaks in the context of less experienced surgeon practices. The results showed that patients in the early cohort experienced higher rates of postoperative CSF leakage compared to those in the late cohort, suggesting that surgeon experience plays a crucial role in the success of endoscopic skull base surgery. To improve outcomes, surgeons should pay attention to basic technical details and reduce the learning curve.
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
(2022)
Article
Clinical Neurology
J. L. Birkenbeuel, A. Abiri, T. Nguyen, B. F. Bitner, E. F. Abello, M. Vasudev, F. P. K. Hsu, E. Kuoy, E. C. Kuan
Summary: The radiographic appearance of the vascularized pedicle nasoseptal flap after endoscopic skull base surgery was described and showed changes over time. Flap enhancement increased significantly with time. The proportion of cases with complete adherence of the nasoseptal flap to the skull base increased on delayed imaging.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2023)
Article
Multidisciplinary Sciences
Vlastimil Novak, L. Hrabalek, J. Hoza, C. Hucko, D. Pohlodek, J. Macura
Summary: The endoscopic endonasal approach for patients with a sellar tumor is a gentle method with minimal impact on sinonasal quality of life over a period longer than six months. Common complaints post-surgery include the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. Cranial base reconstruction using muscle and fascia lata appears to positively influence sinonasal quality of life.
SCIENTIFIC REPORTS
(2021)
Article
Medicine, Research & Experimental
Federico Calvaruso, Alfredo Lo Manto, Nicola Bisi, Carla Cantaffa, Margherita Basso, Giuseppe Ferrulli, Matteo Alicandri-Ciufelli, Daniele Marchioni
Summary: The objective of this study was to propose a standardized surgical technique using the pericranial flap for reconstruction of large anterior skull base defects following resection of ethmoid bone malignancies. The results showed promising outcomes for repairing large defects.
Article
Clinical Neurology
Abdulrazag Ajlan, Sarah Basindwah, Aysha Hawsawi, Mohammed Ali Omar, Saad Alsaleh, Abdulaziz Alrasheed, Ahmad Alroqi, Ashwag Alqurashi
Summary: This study found that the volume and location of pneumocephalus in the early postoperative period of endoscopic skull base surgery (ESBS) are potentially predictive of cerebrospinal fluid (CSF) leak. Patients with larger volumes of intra-axial air and/or multiple air locations are more likely to develop CSF leak.
WORLD NEUROSURGERY
(2023)
Review
Clinical Neurology
Amir H. Zamanipoor Najafabadi, Danyal Z. Khan, Ivo S. Muskens, Marike L. D. Broekman, Neil L. Dorward, Wouter R. van Furth, Hani J. Marcus
Summary: The study evaluated surgical outcomes of the extended endoscopic endonasal approach for tuberculum sellae and olfactory groove meningioma patients over the past two decades. The findings showed a decrease in the occurrence of CSF leak over time, while other surgical outcomes remained stable.
ACTA NEUROCHIRURGICA
(2021)
Article
Otorhinolaryngology
Mohammad Alshareef, Ahmad Alroqi, Hussain Albaharna, Ahmed Alsayed, Saud Alromaih, Abdulaziz S. Alrasheed, Abdulrazag Ajlan, Saad Alsaleh
Summary: A retrospective review of patients who underwent nasoseptal flap reconstruction following endoscopic endonasal approaches showed a decline in postoperative cerebrospinal fluid leakage and lumbar drainage insertion rates over the last three years. However, with increased surgeon experience and standardization of reconstruction techniques, failure rates have decreased. The use of nasoseptal flap with minimal reconstruction is considered a safe procedure for anterior skull base defect reconstruction.
ENT-EAR NOSE & THROAT JOURNAL
(2022)
Article
Otorhinolaryngology
Joerdis Kristin Eden, Arne Boettcher, Christian Stephan Betz
Summary: Congenital anterior skull base defects with meningoencephaloceles causing nasal obstruction and cerebrospinal fluid (CSF) rhinorrhea are rare clinical entities. The use of transnasal endoscopic technique is a minimally invasive, efficient, and safe approach even in the infant population.
ENT-EAR NOSE & THROAT JOURNAL
(2023)
Article
Clinical Neurology
Christopher D. Pool, Vijay A. Patel, Gloria Hwang, Jeremy Barr, Neerav Goyal
Summary: This study validated the use of topical intranasal fluorescein for CSF detection, finding that color change alone is not sufficient to distinguish between CSF, saliva, and saline, but can readily identify blood.
WORLD NEUROSURGERY
(2021)
Article
Surgery
Chang Ki Jang, Soo Jeong Park, Eui Hyun Kim, Jin Mo Cho, Ju Hyung Moon, Kyoung Su Sung, Je Beom Hong, Jaejoon Joon Lim, Minkyun Na, Chang-Ki Hong, Tae Hoon Roh, Jiwoong Oh
Summary: This study developed a pericranial rescue flap for repairing anterior skull base defects via the endonasal approach and demonstrated its feasibility. This minimally invasive repair technique may help resolve neurosurgical complications such as CSF leakage.