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DOI: 10.1055/s-0045-1809631
Endoscopic Treatment of Fluid Fistula Leak: An Analysis of 15 Cases
Tratamento endoscópico de vazamento de fístula de fluido: Uma análise de 15 casosFunding No funding was needed.
Abstract
Objectives
Analyze the effectiveness of the endoscopic endonasal surgical technique for the management and treatment of CSF fistulas by comparing data from literature and the authors' casuistry.
Materials and Methods
This is a retrospective study that included fistula leaks surgically treated by endoscopic approach between 2001 and 2020. In addition, a thorough clinical history, a complete otorhinolaryngological examination, clinical neurological evaluation, and endoscopic evaluation of the nasal cavity, are complemented by laboratory and image tests of the research's population.
Results
All 15 fistulas from the population were spontaneous and not associated with any other etiology, with most of the fistulas being in the fovea ethmoidalis and the cribriform plate. During the endoscopic approach, there were no major complications and blood loss was not reported. Only two presented recurrences of the nasoethmoidal fistula were reoperated, through the endoscopic approach, with no more recurrences reported. About their symptomatology, all patients presented with headache, rhinoliquorrhea, and neck stiffness.
Conclusion
Based on what was presented in this article, the endoscopic surgical repair approach proved to be satisfactory as the results were in line with the literature.
Level of evidence: III – retrospective cohort study.
Resumo
Objetivos
Analisar a efetividade da técnica cirúrgica endoscópica endonasal no manejo e tratamento das fístulas liquóricas, comparando dados da literatura e da casuística dos autores.
Materiais e Métodos
Trata-se de um estudo retrospectivo que incluiu fístulas tratadas cirurgicamente por via endoscópica entre 2001 e 2020. Além disso, história clínica minuciosa, exame otorrinolaringológico completo, avaliação neurológica clínica, avaliação endoscópica da cavidade nasal, complementada por exames laboratoriais e de imagem da população da pesquisa.
Resultados
Todas as 15 fístulas da população foram espontâneas e não associadas a nenhuma outra etiologia, sendo a maioria das fístulas localizada na fóvea etmoidal e na placa cribriforme. Durante a abordagem endoscópica, não houve complicações maiores e a perda sanguínea não foi relatada. Apenas dois apresentaram recidivas da fístula nasoetmoidal e foram operados, por via endoscópica, não havendo mais recidivas relatadas. Quanto à sintomatologia, todos os pacientes apresentavam cefaleia, rinorreia e rigidez de nuca.
Conclusão
Com base no que foi apresentado neste artigo, a abordagem cirúrgica endoscópica do reparo mostrou-se satisfatória, pois os resultados foram condizentes com a literatura.
Nível de evidência: III – Estudo coorte retrospectivo
Publikationsverlauf
Eingereicht: 07. Mai 2024
Angenommen: 20. März 2025
Artikel online veröffentlicht:
16. Juli 2025
© 2025. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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