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External frontal sinusotomy and endoscopic repair of cerebrospinal fluid fistula in the posterior wall: preliminary report of a new technique

Published online by Cambridge University Press:  10 June 2011

P Thulasi Das  and
D Balasubramanian
P Thulasi Das*
Affiliation:
Sinus and Nose Hospital, Chennai, Tamil Nadu, India
D Balasubramanian
Affiliation:
Sinus and Nose Hospital, Chennai, Tamil Nadu, India
*
Address for correspondence: Dr P Thulasi Das, Sinus and Nose Hospital, 35A Santhome High Road, Santhome, Chennai 600004, India Fax:  +91 44 24983828 E-mail: [email protected]
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Abstract

Introduction:

Cerebrospinal fluid rhinorrhoea is the abnormal leakage of cerebrospinal fluid into the nasal cavity. The posterior wall of the frontal sinus can be the site of such leakage. Traditionally, these leaks were repaired via external osteoplastic or neurosurgical approaches. Despite advances in instrumentation, it is difficult to manage superiorly or laterally placed defects endoscopically. We present a new technique of endoscopic repair of frontal sinus posterior wall defects, via access holes drilled in the anterior wall of the frontal sinus.

Study design:

Preliminary study involving patients presenting with frontal sinus cerebrospinal fluid leaks, with defects in the frontal sinus posterior wall, between 2006 and 2010.

Setting:

Patients were treated in a tertiary referral centre for nose and sinus diseases. Patient records were reviewed and analysed.

Results:

Nine patients underwent external frontal sinusotomy under endoscopic vision. Repair was successful in all cases, with no complications. Follow up ranged from three months to three years.

Conclusion:

External frontal sinusotomy and endoscopic repair is a simple, precise and cosmetically acceptable alternative to osteoplastic and major neurosurgical techniques for management of frontal sinus posterior wall defects. This new, previously undescribed technique enables otolaryngologists to play a role in managing such defects.

Keywords

Frontal SinusCerebrospinal FluidSurgical Procedure, Endoscopic
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 8 , August 2011 , pp. 802 - 806
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Marshall, AH, Jones, NS. Cerebrospinal Fluid Rhinorrhoea. In: Gleeson, M, Jones, NS, Burton, MJ, Clarke, R, Browning, G, Luxon, L, Lund, V, Hibbert, J, Watkinson, J, eds. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery, 7th edn.London: Edward Arnold, 2008;1636–44Google Scholar
2Muntarbhorn, K, Thanaviratananich, S. Mini- anterior and combined Frontal Sinosotomy and Drilling of the Nasofrontal Beak. In: Stamm, AC, Draf, W, eds. Micro-endoscopic Surgery of the Paranasal Sinuses and the Skull Base. Berlin: Springer, 2000;279–86Google Scholar
3Ogston, A. Trephining the frontal sinus for catarrahal diseases. Med Chron 1884;1:235–8Google Scholar
4Silcock, AG. Distension by mucous and empyema of the frontal sinus with illustrative cases. Practitioner 1897;141:244–54Google Scholar
5Lothrop, HA. Anatomy and surgery of the frontal sinus and the anterior ethmoidal cells. Ann Surg 1889;29:175–217Google Scholar
6Draf, W. Therapeutic possibilities of endoscopy of the paranasal sinuses. In: Draf, W, ed. Endoscopy of the Paranasal Sinuses. New York: Springer, 1983;44–58CrossRefGoogle Scholar
7Fry, TL, Biggers, WP, Fischer, ND. Frontal sinus trephination: a new technique for office procedure. Laryngoscope 1980;90:838–41CrossRefGoogle ScholarPubMed
8Wigand, WE. Operations. In: Wigand, ME, ed. Endoscopic surgery of the paranasal sinuses and anterior skull base. New York: Thieme, 1990;77–133Google Scholar
9Hoffman, DF, May, M. Endoscopic frontal sinus surgery: frontal trephine permits a ‘two sided’ approach. Oper Tech Otolaryngol Head Neck Surg 1991;2:257– 61CrossRefGoogle Scholar
10Gerber, ME, Myer, CM 3rd, Prenger, EC. Transcutaneous frontal sinus trephination with endoscopic visualization of the nasofrontal communication. Am J Otolaryngol 1993;14:55–9Google Scholar
11Muntarbhorn, K. Anterior and inferior frontal sinusotomy by drilling with burrs. Am J Rhinol 1993;7:191Google Scholar
12Thawley, SE, Deddens, AE. Transfrontal endoscopic management of frontal recess disease. Am J Rhinol 1995;9:307–11CrossRefGoogle Scholar