A Case of Transnasal Endoscopic Repair for Traumatic Cerebrospinal Fluid Rhinorrhea after Multiple Cranial Surgeries

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  • Minami Kazuhiko
    Head and Neck Surgery, Saitama Medical University International Medical Center, Saitama, Japan
  • Sugasawa Masashi
    Head and Neck Surgery, Saitama Medical University International Medical Center, Saitama, Japan

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  • 難治性髄液鼻漏に対する鼻内内視鏡下髄液鼻漏閉鎖術例

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<p>Cerebrospinal fluid (CSF) rhinorrhea involves the drainage of CSF into the nasal cavity due to a breach between the intracranial subarachnoid space and the sinonasal mucosa. It is caused by either trauma, high intracranial pressure, tumors, erosive diseases, or congenital skull defects. The majority of the cases derive from accidental head trauma or iatrogenic injury. Although most of the traumatic CSF rhinorrhea ceases after conservative management, persistent CSF rhinorrhea requires surgical intervention because of an elevated risk of either meningitis or an encephalomeningocele.Transnasal endoscopic repair is increasingly employed to treat patients with persistent CSF rhinorrhea. Although the endoscopic technique requires accurate localization of the breach intraoperatively, endoscopic repair of CSF rhinorrhea is advantageous because it is minimally invasive and provides superior visualization. The fistula site and size, optimal surgical approach, and graft placement should be accurately determined prior to the surgery.Here, we present a case involving transnasal endoscopic repair to successfully treat a CSF rhinorrhea that had persisted for 15 years after a road traffic injury that had required multiple craniotomies. We suggest that the transnasal endoscopic procedure is advantageous even after repeated surgeries and that it should be considered as the preferred treatment for CSF rhinorrhea.</p>

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