Fig 4 - uploaded by Camilo Reyes
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(A) Coronal view of status postfrontal craniectomy. Right anterior ethmoidal air cells opacification (arrowhead) with fracture of ethmoid sinus roof (arrow). (B) Sagittal view shows fracture at the ethmoidofrontal junction (arrow).
Source publication
Objectives To describe two cases of cerebrospinal fluid (CSF) leak repair after gunshot wound to the head.
Design Retrospective review of two cases.
Settings A large regional tertiary care facility.
Participants Two patients with gunshot wounds to the skull base.
Main Outcome Measures Preoperative and postoperative physical and radiologic findings....
Citations
... Frontal CSF leaks that occur spontaneously often occur at regions of wall weakness that rupture under hydrostatic pressure caused by higher ICP, such as anterior cribriform plate, the ethmoid roof, and posterior wall [4]. ...
Introduction
and Objectives: Leakage of cerebrospinal fluid (CSF) from the frontal sinus is a challenging condition facing the ENT surgeon. Repair of this condition has been changed nowadays due to the newer instruments and techniques of nasal endoscopy. This study aims to evaluate the outcome of frontal sinus CSF leak endoscopic repair.
Patients and methods
Twenty-seven patients who had frontal sinus CSF leaks were included in this study. They were 9 females and 18 males. They underwent endoscopic repair of the leak site at the period of five years from 2015 to 2020. A retrospective evaluation of these patients includes reconstructive procedures, complications, and postoperative follow-up.
Results
The frontal leaks were present in the frontal recess (8 patients, 29.6%), ethmoidal roof (5 patients, 18.5%), and the majority was in the posterior wall (14 patients, 51.9%); 11 in the medial side and 3 in the lateral side. All cases, 27 (100%) were treated successfully, no failed treatment was observed. Postoperative complications were minimal; two patients had elevated intracranial pressure (ICP), infection with fever were found in four patients (7.4%), and meningitis was observed in only two cases (7.4%), treated conservatively.
Conclusion
For frontal sinus CSF leak repair, the endonasal endoscopic approach is the treatment of choice due to higher success rates and lower morbidity profile. A favorable result is possible with proper diagnosis, precise localization, and an appropriate strategy.
