Endoscopic closure of the Eustachian tube orifice for refractory lateral skull base cerebrospinal fluid leak using autologous fat graft: illustrative case.
Publication/Presentation Date
2-7-2022
Abstract
BACKGROUND: Rhinorrhea due to lateral skull base cerebrospinal fluid (CSF) leaks can be a challenge to manage. Multiple strategies exist for treating CSF leaks in this region including direct repair, posterior Eustachian tube packing, and CSF diversion. Endonasal closure of the Eustachian tube has been reported using cerclage and mucosal flaps.
OBSERVATIONS: We present the first reported case of endoscopic autologous fat packing of the Eustachian tube orifice to repair a CSF leak. In this case a 42-year-old woman who underwent middle fossa meningioma resection 20 years ago presented with refractory CSF rhinorrhea despite blind sac closure of the ear canal. This persisted after CSF diversion and only resolved after endoscopic endonasal Eustachian tube closure described herein.
LESSONS: This technique is simple to perform with minimal risk of morbidity. Eustachian tube orifice fat packing may be particularly useful for patients with refractory CSF rhinorrhea with low CSF pressure.
Volume
3
Issue
6
ISSN
2694-1902
Published In/Presented At
Mehta, G. U., Fatima, N., Lekovic, G. P., & Slattery, W. H. (2022). Endoscopic closure of the Eustachian tube orifice for refractory lateral skull base cerebrospinal fluid leak using autologous fat graft: illustrative case. Journal of neurosurgery. Case lessons, 3(6), CASE21590. https://doi.org/10.3171/CASE21590
Disciplines
Medicine and Health Sciences
PubMedID
36130556
Department(s)
Department of Surgery Faculty
Document Type
Article