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Cerebrospinal fluid rhinorrhoea as a complication of endoscopic endonasal reduction of blowout fractures

Published online by Cambridge University Press:  12 July 2012

D-G Lee
Affiliation:
Department of Otorhinolaryngology, Medical Research Institute, Pusan National University School of Medicine, Busan, South Korea Medical Research Institute, Pusan National University School of Medicine, Busan, South Korea
K-S Cho*
Affiliation:
Department of Otorhinolaryngology, Medical Research Institute, Pusan National University School of Medicine, Busan, South Korea Medical Research Institute, Pusan National University School of Medicine, Busan, South Korea
H-J Kim
Affiliation:
Department of Radiology, Medical Research Institute, Pusan National University School of Medicine, Busan, South Korea
H-J Roh
Affiliation:
Department of Otorhinolaryngology, Pusan National University School of Medicine Yangsan Hospital, South Korea
*
Address for correspondence: Dr Kyu-Sup Cho, Department of Otorhinolaryngology, Pusan National University School of Medicine, 1-10 Ami-dong, Seo-gu, Busan 602-739, South Korea Fax: +82 51 246 8668, E-mail: [email protected]

Abstract

Background:

Unless the orbital contents are supported, the insertion of nasal packing material during endoscopic endonasal surgery may cause serious intracranial complications such as cerebrospinal fluid leakage.

Methods:

Case report and literature review.

Results:

We report a patient with iatrogenic cerebrospinal fluid rhinorrhoea caused by intracranial entry of a Silastic sheet inserted into the nasal cavity. This skull defect and the surrounding skull base were successfully reconstructed in a multilayer fashion via an endoscopic endonasal approach.

Conclusion:

This case highlights the need for caution when inserting nasal packing material. During endoscopic endonasal reduction of blowout fractures, great care must be taken to support the orbital contents, in order to avoid serious intracranial complications such as cerebrospinal fluid leakage.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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References

1Hinohira, Y, Takahashi, H, Komori, M, Shiraishi, A. Endoscopic endonasal management of medial orbital blowout fractures. Facial Plast Surg 2009;25:1722CrossRefGoogle ScholarPubMed
2Mohadjer, Y, Hartstein, ME. Endoscopic orbital fracture repair. Otolaryngol Clin North Am 2006;39:1049–57CrossRefGoogle ScholarPubMed
3Hinohira, Y, Yumoto, E, Shimamura, I. Endoscopic endonasal reduction of blowout fractures of the orbital floor. Otolaryngol Head Neck Surg 2005;133:741–7CrossRefGoogle ScholarPubMed
4Wu, W, Yan, W, Cannon, PS, Jiang, AC. Endoscopic transethmoidal and transconjunctival inferior fornix approaches for repairing the combined medial wall and orbital floor blowout fractures. J Craniofac Surg 2011;22:537–42CrossRefGoogle Scholar
5Burnstine, MA. Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis. Ophthalmology 2002;109:1207–10CrossRefGoogle ScholarPubMed
6Park, CH, Choi, DJ, Lee, JH, Hong, SM, Kwon, TK, Joung, HH et al. Endoscopic reduction of medial orbital wall fractures using the rolled silastic sheet technique. J Trauma 2009;66:1421–4Google ScholarPubMed