The treatment of cerebrospinal fluid rhinorrhea:a report of 82 cases / 中国微创外科杂志

Objective To summarize our experience in managing cerebrospinal fluid(CSF) rhinorrhea. Methods 82 cases of cerebrospinal fluid rhinorrhea treated in our department from 1995 to 1999 were reviewed retrospectively. 61 were male and 21 were female.They ranged from 2 to 82 years old.CSF leak was caused by trauma in 43 cases,iatrogenic injury in 18 cases and spontaneous leak occurred in 21 cases. Results 36 cases underwent surgical repair.The closure rate was 86 11%.Otorhinolaryngologists underwent 25 cases,and 23 cases succeeded (92%).The department of neurology underwent 11 cases,and 8 cases succeeded (72 7%). Conclusions The repair of CSF leak through transnasal extracranial approach can obtain better therapeutic results,especially through intranasal endoscopy.

Intranasal Endoscopic Diagnosis and Treatment in Congenital Nasolacrimal Duct Obstruction

This study is to demonstrate the effectiveness of intranasal endoscopy during silicone tube insertion in children with congenital nasolacrimal duct obstruction. Participants were 10 children with symptoms of epiphora since birth. They underwent silicone tube insertion during the period of July 1998 to November 1999. Three were female and seven male. Mean age was 25.8 months, ranging from 15 to 44 months. Probing had been failed in five of them, once in two children and twice in the other three. Silicone tube insertion was done after identifying the cause of probing failure by observing the probe tip with intranasal endoscopy. The cause of tearing confirmed by intranasal endoscopic examination were mucosal obstruction in 5 cases, submucosal passing of the probe in 4 cases and obstruction due to pus collection in one case. In 4 cases in which the probe had passed into submucosal space, probing succeeded in three cases by placing the probe tip medially(nasal direction). There was accompanying abnormal bony structure in the other one case and we had to bend the probe tip with ethmoid forceps into nasal cavity to form the lacrimal pathway. When probing fails or is difficult to do due to poor cooperation, identifying the cause of failure with intranasal endoscopic examination and inserting silicone tube under direct visualization can minimize intranasal trauma and will lead to good outcome.

A Case of Intranasal Meningoencephalocele / 대한이비인후과학회지

Meningoencephalocele is an ectopic protrusion of the meninges and a portion of the brain that retains connection with the CNS through a defect in the bony covering. It is a rare developmental anomaly that results from faulty closure of the embryonic neural tubes. Meningoencephalocele is usually classified into occipital, sincipital and basal types according to the location and among these, the basal type is less frequently encountered than other types. The authors have experienced a case of basal-type intranasal meningoencephalocele in 4 year-old male patient, which was removed successfully via bifrontal craniotomy and intranasal endoscopic approach, and the defect of skull base was repaired by inner table of the cranium and septal mucosa with good result.