Document Detail


Management of unexpected cerebrospinal fluid fistulae during endoscopic sinus surgery.
MedLine Citation:
PMID:  17999799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to determine the incidence and perioperative management of patients with cerebrospinal fluid (CSF) fistulas during endoscopic sinus surgery (ESS) in New York State. METHODS: A questionnaire was mailed to otolaryngologists in New York State who were registered with the American Academy of Otolaryngology, Head and Neck Surgery in November 2005. Questions addressed the incidence and perioperative care of patients with successful closure of unexpected CSF fistula during ESS. RESULTS: Twenty-five percent of respondents have experienced at least one episode of unexpected CSF fistula during ESS over the prior 5 years, with a calculated incidence of 0.16%. Surgeons most often (46%) observed patients for 1-2 days. Antibiotics were used in 93% of patients. A lumbar drain was most commonly not used. Repair techniques most often used an intranasal flap or graft (92%). CONCLUSION: The incidence of unexpected CSF fistula during ESS may be lower than previously reported. A majority of surgeons use an intranasal flap or graft in repair with antibiotic use, with no consensus regarding use of lumbar drain or inpatient observation. More study is needed to determine consensus algorithms for management of CSF leaks during ESS.
Authors:
Michael P Platt; David Shaye; Steven M Parnes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of rhinology     Volume:  21     ISSN:  1050-6586     ISO Abbreviation:  Am J Rhinol     Publication Date:    2007 Sep-Oct
Date Detail:
Created Date:  2007-11-16     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807268     Medline TA:  Am J Rhinol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  611-4     Citation Subset:  IM    
Affiliation:
Division of Otolaryngology, Albany Medical College, Albany, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Cerebrospinal Fluid / chemistry*
Cerebrospinal Fluid Otorrhea / etiology,  prevention & control*
Endoscopy / adverse effects*,  methods*
Fistula / pathology,  radiography,  surgery*
Humans
Nasal Cavity / surgery*
Otolaryngology / instrumentation,  methods*
Otorhinolaryngologic Surgical Procedures / methods
Postoperative Complications / etiology,  prevention & control*
Questionnaires
Reproducibility of Results
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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