Cerebrospinal Fluid Rhinorrhea Secondary to Idiopathic Intracranial Hypertension: Long-term Outcomes of Endoscopic Repairs

• DOI: 10.2500/ajra.2016.30.4319
• Publication Date: 2016-07-23T00:58:28Z
• Authors: Raewynn G. Campbell; Douglas Farquhar; Nina Zhao; Alexander G. Chiu; Nithin D. Adappa; James N. Palmer
• Keywords: Pseudotumor cerebri; Acetazolamide; Encephalocele; Cerebrospinal fluid leak; Cribriform plate; Cerebrospinal Fluid Rhinorrhea; Dural venous sinuses; Sinus (botany)

Endoscopic endonasal repair of cerebrospinal fluid (CSF) rhinorrhea secondary to idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri or benign hypertension, has varying success rates, from 25-87%, with minimal morbidity. However, often these series have a relatively short-term follow-up. Given the pathophysiology IIH, long-term follow-up is necessary identify true CSF leak recurrence rates. Our investigation aimed evaluate outcomes in endoscopically repaired leaks.A retrospective chart review all patients due IIH who met inclusion criteria between 1996 and 2009. Outcome measures included following: demographics, pressure, location skull base defect, presence encephalocele and/or meningoencephalocele, surgical technique, treatment acetazolamide, whether ventriculoperitoneal shunt was inserted, recurrence, history meningitis previous sinus surgery, duration follow-up.Thirty-two total 44 defects were reviewed over mean 10.2 years. The body mass index pressure 36.8 kg/m(2) 27.7 cm H2O, respectively. Seven (18%) required revision surgery at same site distant site. We found no statistical significance that identified risk outcome measurements most likely our small failure rate. early recurrences noted recur site, whereas late along base.IIH an increasingly recognized entity treated by otorhinolaryngologists. present first series. Long-term because delayed leaks occur this population.