Transsphenoidal Endoscopic Approach in Treatment of Spontaneous Nasal CSF-leak
Journal of Surgery
Volume 7, Issue 6, December 2019, Pages: 198-201
Received: Nov. 13, 2019; Accepted: Dec. 11, 2019; Published: Dec. 23, 2019
Views 88      Downloads 55
Sergei Karpishchenko, Department of Otorhinolaringology, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
Vladislav Cherebillo, Department of Neurosurgery, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
Olga Vereshchagina, Department of Otorhinolaringology, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
Nikita Puzakov, Department of Neurosurgery, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
Olga Stancheva, Department of Otorhinolaringology, Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia
Article Tools
Follow on us
Spontaneous nasal liquorrhea is a pathological condition associated with defects between the nasal cavity and the intracranial structures, which results in CSF leak from the nasal cavity. Diagnostic criteria include: anamnesis, examination of the nasal fluid, endoscopic examination of the nasal cavity, and CT - and MRI - cisternography. Conservative therapy is applicable to small fistulas. In the case of the inefficiency of this method, surgical method is then applied to the defect closure. Purpose of the study: To evaluate the effectiveness of endoscopic endonasal approach in the CSF leak treatment. Materials and methods: For the period from 2008 to 2018 at the Pavlov First Saint Petersburg State Medical University, at the clinic of neurosurgery of the Kirov Medical Institute and the Medical Research Center Almazov, 38 patients with spontaneous nasal liquorrhea were treated. All patients underwent plastic surgery of the CSF fistula by endoscopic endonasal approach. Results: In 4 cases, there was a large defect requiring secondary surgical intervention 1-2 weeks after the initial operation. Conclusions: The use of auto tissues (muscle or fat) is the method of choice for repeated surgical plastics of the cerebrospinal fluid fistula or in the case of a large size defect.
Nasal Liquorrhea, Skull Base, Autograph
To cite this article
Sergei Karpishchenko, Vladislav Cherebillo, Olga Vereshchagina, Nikita Puzakov, Olga Stancheva, Transsphenoidal Endoscopic Approach in Treatment of Spontaneous Nasal CSF-leak, Journal of Surgery. Vol. 7, No. 6, 2019, pp. 198-201. doi: 10.11648/j.js.20190706.19
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Shintoku, R., Tosaka, M., Shimizu, T., and Yoshimoto, Y. (2018). Transcranial and epidural approach for spontaneous cerebrospinal fluid leakage due to meningoencephalocele of the lateral sphenoid sinus. Asian journal of neurosurgery. 13 (2): 462.
Subhanov, K. S., Abdulkerimov, V. Y., Cherebillo, V. Y., Svistov, D. V., and Konovalov, P. P. (2017). Surgical treatment of nasal liquorrhea. Uralskiy meditsinskiy zhurnal. 150 (6): 122-126.
Karpishchenko, S. A., Voloshina, A. V., Stancheva, O. A. and Yusupov, D. (2019). Acute isolated sphenoiditis: tactics and treatment. Zhurnal Vrach. Vol. 4: 259-261.
Shelesko, E. V., Kravchuk, A. D., Kapitanov, D. N., Chernikova, N. A., and Zinkevich, D. N. (2018). A modern approach to the diagnosis of nasal liquorrhea. Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko. 82 (3): 103-111.
Vlasova, M. M., and Piskunov, I. S. (2016). The possibilities of computed tomography in the diagnosis of spontaneous nasal liquorrhea. Ros. otorhinolaryngologia. 24 (2): 13-19.
Karpishchenko, S. A., Cherebillo, V. Y., Tamazyan, N. V ., Puzakov, N. S., Stancheva, O. A. and Danilova, D. M. (2018). Features of endonasal transsphenoidal access in the surgical volume of the pituitary adenoma. Ros. otorhinolaryngologia. Vol. 3: 47-53.
Larin, R. А., and Pisarev, Е. N. (2013). Spontaneous liquorrhea nasalis when skull base defects is located in sphenoidal sinus. Sovremennyye tekhnologii v meditsine. 5 (3): 122-123.
Martínez-Capoccioni, G., Serramito-García, R., Martín-Bailón, M., García-Allut, A., and Martín-Martín, C. (2017). Spontaneous cerebrospinal fluid leaks in the anterior skull base secondary to idiopathic intracranial hypertension. European Archives of Oto-Rhino-Laryngology. 274 (5): 2175-2181.
Lobo, B. C., Baumanis, M. M., and Nelson, R. F. (2017). Surgical repair of spontaneous cerebrospinal fluid (CSF) leaks: A systematic review. Laryngoscope investigative otolaryngology. 2 (5): 215-224.
Gofman, V. R., Andronenkov, V. A., and Voronov, A. V. (2012). The substantiation of the approach for endoscopic surgery of nasal liquorrhea. Vestnik otorinolaringologii. Vol. 4: 16-17.
Kljajić, V., Vuleković, P., Vlaški, L., Savović, S., Dragičević, D., and Papić, V. (2017). Endoscopic repair of cerebrospinal fluid rhinorrhea. Brazilian Journal of Otorhinolaryngology. 83 (4): 388-393.
Piskunov, V. S. and Nikitin, N. A. (2016). Possibilities of endoscopic surgery in the treatment of nasal liquorrhea. Innova. Vol. 4: 5.
Schwartz, T. H., Fraser, J. F., Brown, S., Tabaee, A., Kacker, A., and Anand, V. K. (2008). Endoscopic cranial base surgery: classification of operative approaches. Neurosurgery. 62 (5): 991-1005.
Chaaban, M. R., Illing, E., Riley, K. O., and Woodworth, B. A. (2014). Spontaneous cerebrospinal fluid leak repair: a five-year prospective evaluation. The Laryngoscope. 124 (1): 70-75.
Gaidukov, S. S., and Naumenko, A. N. (2014). Criteria for choosing a method for plasty of defects in the base of the skull in patients with nasal liquorrhea. Ros. otorhinolaryngologia. Vol. 1: 33-36.
Karpishchenko, S. A., Stancheva, O. A. and Suvorkina, A. D. (2017). Features of the diagnosis and treatment of isolated fungal lesions of the sphenoid sinus. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae. 23 (3): 50-57.
Sharipov, O. I., Kutin, M. A., Bayuklin, A. V., Imaev, A. A., Abdilatipov, A. A., Kurnosov, A. B., Fomichev, D. V., Mikhaylov, N. I., and Kalinin, P. L. (2018). The use of platelet gel for repair of a cerebrospinal fluid fistula of the skull base (a case report and literature review). Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko. 82 (1): 86-92.
Polezhaev, A. V., Cherebillo, V. Y., Svistov, D. V., Tsoy, D. V., and Voycehovskiy, D. V. (2018). Transsphenoid surgery of nasal liquorrhea as a complication of drug treatment with prolactin. Vestnik khirurgii imeni I. I. Grekova. 177 (3): 14-18.
Pashaev, B. Y., Bochkarev, D. V., Danilov, V. I., Krasnozhen, V. N., and Vagapova, G. R. (2015). The prevention and treatment of nasal liquorrhea in transnasal surgery of the base of the skull. Vestnik otorinolaringologii. 80 (4): 34-37.
Gaivoronsky, A. I., Kondakov, E. N., Svistov, D. V., and Gulyaev, D. A. (2015). Surgical access in neurosurgery (a guide for doctors). By decision of the scientific council VMedA. Edited by B. V. Gaidar. SPb.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186