J Neurol Surg Rep 2016; 77(02): e83-e85
DOI: 10.1055/s-0036-1584079
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Removal of a Bullet in Rosenmuller Fossa: Case Report

Joshua D. Burks
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Chad A. Glenn
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Andrew K. Conner
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Phillip A. Bonney
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Jose A. Sanclement
2   Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Michael E. Sughrue
1   Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
› Institutsangaben
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Publikationsverlauf

28. Januar 2016

05. April 2016

Publikationsdatum:
02. Juni 2016 (online)

Abstract

Fractures of the anterior skull base may occur in gunshot victims and can result in traumatic cerebrospinal fluid (CSF) leak. Less commonly, CSF leaks occur days or even weeks after the trauma occurred. Here, we present the case of a 21-year-old man with a delayed-onset, traumatic CSF leak secondary to a missile injury that left a bullet fragment in the Rosenmuller fossa. The patient was treated successfully with endoscopic, endonasal extraction of the bullet, and repair with a nasal septal flap. Foreign bodies lodged in Rosenmuller fossa can be successfully treated with endoscopic skull base surgery.

Funding Source

None.


 
  • References

  • 1 Betz P, Stiefel D, Hausmann R, Eisenmenger W. Fractures at the base of the skull in gunshots to the head. Forensic Sci Int 1997; 86 (3) 155-161
  • 2 Spetzler RF, Zabramski JM. Cerebrospinal fluid fistula. Contemp Neurosurg 1986; 8: 1-7
  • 3 Greenberg M. Handbook of Neurosurgery. 6th ed. New York, NY: Thieme Medical Publishers; 2006: 174-178
  • 4 Chong VF, Fan YF. Radiology of the nasopharynx: pictorial essay. Australas Radiol 2000; 44 (1) 5-13
  • 5 Silver AJ, Mawad ME, Hilal SK, Sane P, Ganti SR. Computed tomography of the nasopharynx and related spaces. Part I: Anatomy. Radiology 1983; 147 (3) 725-731
  • 6 Jaffe B, Welch K, Strand R, Treves S. Cerebrospinal fluid rhinorrhea via the fossa of Rosenmuller. Laryngoscope 1976; 86 (7) 903-907
  • 7 Hatch NU, Riley KO, Woodworth BA. Endoscopic removal of a bullet penetrating the middle cranial fossa. Skull Base Rep 2011; 1 (1) 47-50
  • 8 Hasheminia D, Kalantar Motamedi MR, Hashemzehi H, Nazeri R, Movahedian B. A 7-year study of 1,278 patients with maxillofacial trauma and cerebrospinal fluid leak. J Maxillofac Oral Surg 2015; 14 (2) 258-262
  • 9 Meirowsky AM, Caveness WF, Dillon JD , et al. Cerebrospinal fluid fistulas complicating missile wounds of the brain. J Neurosurg 1981; 54 (1) 44-48
  • 10 Schoentgen C, Henaux PL, Godey B, Jegoux F. Management of post-traumatic cerebrospinal fluid (CSF) leak of anterior skull base: 10 years experience. Acta Otolaryngol 2013; 133 (9) 944-950
  • 11 El-Sayed IH, Roediger FC, Goldberg AN, Parsa AT, McDermott MW. Endoscopic reconstruction of skull base defects with the nasal septal flap. Skull Base 2008; 18 (6) 385-394
  • 12 Archer JB, Sun H, Bonney PA , et al. Extensive traumatic anterior skull base fractures with cerebrospinal fluid leak: classification and repair techniques using combined vascularized tissue flaps. J Neurosurg 2016; 124 (3) 647-656
  • 13 Gruss CL, Al Komser M, Aghi MK , et al. Risk factors for cerebrospinal leak after endoscopic skull base reconstruction with nasoseptal flap. Otolaryngol Head Neck Surg 2014; 151 (3) 516-521