+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Surgical Management of Sphenoid Sinus Lateral Recess Cerebrospinal Fluid Leaks: A Single Neurosurgical Center Analysis of Endoscopic Endonasal Minimal Transpterygoid Approach



Surgical Management of Sphenoid Sinus Lateral Recess Cerebrospinal Fluid Leaks: A Single Neurosurgical Center Analysis of Endoscopic Endonasal Minimal Transpterygoid Approach



World Neurosurgery 118: E473



To review the results of sphenoid sinus lateral recess (SSLR) cerebrospinal fluid (CSF) leaks treated with the endoscopic endonasal minimal transpterygoid approach (EEMTPA) and to discuss the surgical technique and outcomes. We performed a retrospective analysis of 13 cases who underwent SSLR CSF leak repair through the EEMTPA in our clinic between September 2008 and December 2017. Demographic and etiological features with reconstruction and surgical outcomes were examined. Mean follow-up time was 6.1 years. In regard to etiology, the SSLR CSF leaks included 9 patients with spontaneous, 2 patients with traumatic, and 2 with iatrogenic causes. CSF leak was at the left lateral recess in 8 cases and at right lateral recess in 5 cases. Nine patients had empty sella syndrome, and 11 patients had meningoencephaloceles in addition to SSLR CSF leaks. All patients underwent surgery through the EEMTPA, and a multilayer closure with tissue overlay grafts were used for reconstruction. A pedicled nasoseptal flap and/or pedicled middle turbinate flap were applied to the area of the leak in all cases. One patient had a persistent CSF leak and another had recurrence, both of which required revision surgery. Our overall success rate was 100%. EEMTPA is a safe and effective method that can be used to treat challenging pathologies at the SSLR, including CSF leaks accompanying meningoencephaloceles. Furthermore, the success rate of EEMTPA for SSLR CSF leaks can be increased by applying endoscopic skull base reconstruction techniques such as the pedicled nasoseptal flap and pedicled middle turbinate flap.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065548472

Download citation: RISBibTeXText

PMID: 29981913

DOI: 10.1016/j.wneu.2018.06.219


Related references

Endonasal transpterygoid approach for lateral sphenoid recess cerebrospinal fluid leaks: Technical aspects. Neurology India 67(1): 73, 2019

Endoscopic transpterygoid repair of cerebrospinal fluid leaks from lateral recess of sphenoid. Neurology India 67(1): 71-72, 2019

Endoscopic repair of cerebrospinal fluid leaks in the lateral sphenoid sinus recess. Journal of Neurosurgery 112(2): 444-448, 2010

Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles. Neurosurgical Focus 32(6): E5, 2012

Lateral Transorbital Versus Endonasal Transpterygoid Approach to the Lateral Recess of the Sphenoid Sinus-A Comparative Anatomic Study. Operative Neurosurgery 16(5): 600-606, 2019

A modification of endoscopic endonasal approach for management of encephaloceles in sphenoid sinus lateral recess. European Archives of Oto-Rhino-Laryngology 273(12): 4305-4314, 2016

Endoscopic repair of lateral sphenoid recess cerebrospinal fluid leaks. Indian Journal of Otolaryngology and Head and Neck Surgery 64(2): 188-192, 2012

Treatment strategies for lateral sphenoid sinus recess cerebrospinal fluid leaks. Archives of Otolaryngology--Head and Neck Surgery 138(5): 471-478, 2012

Endoscopic transpterygoid approach to the lateral sphenoid recess: surgical approach and clinical experience. Otolaryngology--Head and Neck Surgery 133(1): 20-26, 2005

Endonasal endoscopic repair of cerebrospinal fluid leaks of the sphenoid sinus. Archives of Otolaryngology--Head and Neck Surgery 129(5): 576-580, 2003

A Unique Case of Bilateral Recurrent Sphenoid Sinus Cerebrospinal Fluid Leaks: Primary Acquired Leak Within the Lateral Sphenoid Sinus Recess, Followed by a Leak via Sternberg's Canal. Annals of Otology Rhinology and Laryngology 124(8): 593-597, 2015

Endoscopic Endonasal Repair of Sphenoid Sinus Cerebrospinal Fluid Leaks: Our Experience. Indian Journal of Otolaryngology and Head and Neck Surgery 67(4): 412-416, 2015

The endoscopic endonasal approach to the lateral recess of the sphenoid sinus via the pterygopalatine fossa: comparison of endoscopic and radiological landmarks. Neurosurgery 59(4 Suppl 2): Ons237, 2006

Endoscopic management of sphenoid sinus cerebrospinal fluid leaks. Annals of Otology, Rhinology, and Laryngology 117(1): 32-39, 2008

Spontaneous sphenoid wing meningoencephaloceles with lateral sphenoid sinus extension: the endoscopic transpterygoid approach. Journal of Neurological Surgery. Part B Skull Base 75(5): 314-323, 2014