Treatment of cerebrospinal fluid leakage by neuroendoscopic techniques: an analysis of 5 cases / 中华神经医学杂志

ABSTRACT

Objective To explore the effect of neuroendoscopic techniques on treating cerebrospinal fluid (CSF) leakage.Methods Five patient with CSF leakage,admitted to our hospital from November 2012 to April 2013 and treated with surgery under neuroendoscope,were chosen in our study; their clinical data were retrospectively analyzed; the diagnostic methods,surgical methods and clinical effects were summarized.Results Two had traumatic CSF leakage and 3 had iatrogenic CSF leak.In patients with traumatic CSF leakage,brain MR,thin CT scan,skull base reconstruction and cistermography CT were used to determine the location of ventages,while the ventages in patients with iatrogenic CSF leakage can be determined according to clinical experience; the ventages located in the frontal sinus,the ethmoid sinus,the bottom of the saddle,the recessus sphenoethmoidalis,and the border area of middle skull base and parasellar.Direct observation of the ventages was achieved and repair was finished successfully.Follow up for at least three months showed no recurrence or complications.Conclusions Preoperative localization of the ventage of CSF leakage is every important; combination of brain MR,thin CT scan and skull base reconstruction and cistermography CT can accurately locate the ventage in patients with traumatic CSF leakage; for patients with iatrogenic CSF leakage,location of the ventage can be achieved according to clinical experiences.Neuroendoscopy is minimally invasive and having direct view and high success rate,which can be used as the preferred choice for CSF leakage.