Endoscopic repair of cerebrospinal fluid leak in paediatric patients |
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| Affiliation: | 1. Division of Mental Health, Norwegian Institute of Public Health, 0403 Oslo, Norway;2. Division of Epidemiology, Norwegian Institute of Public Health, 0403 Oslo, Norway;3. Department of Obstetrics and Gynecology and Institute of Clinical Medicine, Akershus University Hospital, 1478 Lørenskog, Norway;1. The Children''s Hospital at Westmead, Westmead, NSW, Australia;2. Nottingham University Hospitals, Nottingham, United Kingdom;3. University of Sydney, Discipline of Paediatrics and Child Health, Darlington, NSW, Australia;1. Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan;2. Department of Pediatrics, Japanese Red Cross Kyoto Daini Hospital, Haruobi-cho 355-5, Kamigyo-ku, Kyoto 602-8026, Japan;1. Université des Sciences et Techniques de Masuku, BP: 943 Franceville, Gabon;2. Université de Lorraine, 34 cours Léopold 54000 Nancy, France;1. Respiratory Endoscopy Unit, Department of Paediatric Anesthesia and Intensive Care, Meyer Children Hospital, Florence, Italy;2. Pediatric Cardiology Unit, Meyer Children Hospital, Florence, Italy;3. Department of Paediatrics, Parma Children Hospital, Parma, Italy;4. Pediatric Cardiac Surgery, Heart Hospital, G. Monasterio Tuscany Foundation, Massa, Italy;5. Department of Anesthesia and Intensive Care, Ospedale Riuniti di Foggia, Foggia, Italy;1. School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, United States;2. Facial Plastic and Reconstructive Surgery, Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States;3. West Texas Craniofacial Center of Excellence, Lubbock, TX, United States |
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| Abstract: | BackgroundIn scientific literature exist fewer case series regarding endoscopic treatment of paediatric cerebrospinal fluid fistulas. Compared to craniotomy endoscopic repair does not reach wider consent even if craniotomy carries higher complications rate.ObjectiveThe aim of the present study was to report our institutional experience on paediatric cerebrospinal fluid leak to demonstrate the safety and efficacy of the endoscopic approach in a variety of cases.MethodsClinical records of all paediatric patients who underwent endoscopic repair of anterior and middle fossa skull base defects are reviewed for several parameters.Results10 patients were enrolled, 6 males and 4 females with a mean age of 10 years. The aetiology of the leak was congenital in 2 cases, trauma-induced in 6 cases and iatrogenic in 2 cases. In all the cases the defect was localized by computed tomography. Remedial was obtained using multiple grafts technique with autologous materials during a single procedure in all but one case, this one case requiring a second operation for delayed recurrence. The mean follow-up duration is 36 months.ConclusionCSF fistulas can be approached in paediatrics of any age with high success and low complications rate using the endonasal technique. |
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| Keywords: | Paediatric cerebrospinal fluid leak Rhinorrhea Endoscopic repair Meningoencephalocele Endonasal approach Paediatric neurosurgery |
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