Nasocranialis fistulák zárása "káddugó" technikával és többrétegu rekonstrukcióval

Zalán Piski, A. Büki, Nelli Nepp, András Burián, Péter Révész, Imre Gerlinger

Research output: Article

1 Citation (Scopus)

Abstract

Background and purpose: In case of dehiscenses developing on the anterior scull base, complete closure resulting in the cessation of the communication between the nasal cavity and the intracranial space is mandatory as soon as possible, in order to prevent serious complications. With the development of the endoscopic techniques, the endonasal management for the reconstruction has become available in recent decades. Methods: We aim to present the reconstruction techniques applied in our department in the cases of two patients recently operated at our institute. The choice of methods primarily depends on the size and the localization of the defect. Dehiscenses under 5 mm of diameter can be closed with the so called "bath-plug" technique, while bigger defects, where the required closure of the plug is not possible, can be solved with multilayer reconstruction. We use autogenous fascia, fat and muco-periosteum in both cases. Results: Our patient, who underwent the aforementioned "bath-plug" procedure, could be discharged after a few days of uneventful postoperative period. During a tenmonth follow-up period new fistula formation was not observed. In the case of a patient who underwent multilayer reconstruction, meningitis occurred postoperatively, which was resolved after antibiotic therapy. During a 17-month follow-up period recurrent liquorrhoea did not occur. Conclusion: With suitable technical background and appropriate endoscopic skills the surgeries of the anterior skull base cerebrospinal fluid fistulas can be performed efficiently and with low complication rate. These are minimally invasive procedures accompanied by less surgical trauma, morbidity and shorter hospitalization, hence these techniques are considered to be cost-effective and well-tolerated for the patients.

Original languageHungarian
Pages (from-to)211-216
Number of pages6
JournalIdeggyogyaszati Szemle
Volume69
Issue number5-6
DOIs
Publication statusPublished - máj. 30 2016

Fingerprint

Baths
Fistula
Skull Base
Periosteum
Nasal Cavity
Fascia
Meningitis
Postoperative Period
Cerebrospinal Fluid
Hospitalization
Fats
Communication
Anti-Bacterial Agents
Morbidity
Costs and Cost Analysis
Wounds and Injuries
Therapeutics

Keywords

  • Endoscope
  • Ess
  • Fistula
  • Liquor cerebrospinal
  • Liquorrhoea
  • Scala anterior

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Nasocranialis fistulák zárása "káddugó" technikával és többrétegu rekonstrukcióval. / Piski, Zalán; Büki, A.; Nepp, Nelli; Burián, András; Révész, Péter; Gerlinger, Imre.

In: Ideggyogyaszati Szemle, Vol. 69, No. 5-6, 30.05.2016, p. 211-216.

Research output: Article

Piski, Zalán ; Büki, A. ; Nepp, Nelli ; Burián, András ; Révész, Péter ; Gerlinger, Imre. / Nasocranialis fistulák zárása "káddugó" technikával és többrétegu rekonstrukcióval. In: Ideggyogyaszati Szemle. 2016 ; Vol. 69, No. 5-6. pp. 211-216.
@article{2afb492534f54f0a9c37fd4062c00b34,
title = "Nasocranialis fistul{\'a}k z{\'a}r{\'a}sa {"}k{\'a}ddug{\'o}{"} technik{\'a}val {\'e}s t{\"o}bbr{\'e}tegu rekonstrukci{\'o}val",
abstract = "Background and purpose: In case of dehiscenses developing on the anterior scull base, complete closure resulting in the cessation of the communication between the nasal cavity and the intracranial space is mandatory as soon as possible, in order to prevent serious complications. With the development of the endoscopic techniques, the endonasal management for the reconstruction has become available in recent decades. Methods: We aim to present the reconstruction techniques applied in our department in the cases of two patients recently operated at our institute. The choice of methods primarily depends on the size and the localization of the defect. Dehiscenses under 5 mm of diameter can be closed with the so called {"}bath-plug{"} technique, while bigger defects, where the required closure of the plug is not possible, can be solved with multilayer reconstruction. We use autogenous fascia, fat and muco-periosteum in both cases. Results: Our patient, who underwent the aforementioned {"}bath-plug{"} procedure, could be discharged after a few days of uneventful postoperative period. During a tenmonth follow-up period new fistula formation was not observed. In the case of a patient who underwent multilayer reconstruction, meningitis occurred postoperatively, which was resolved after antibiotic therapy. During a 17-month follow-up period recurrent liquorrhoea did not occur. Conclusion: With suitable technical background and appropriate endoscopic skills the surgeries of the anterior skull base cerebrospinal fluid fistulas can be performed efficiently and with low complication rate. These are minimally invasive procedures accompanied by less surgical trauma, morbidity and shorter hospitalization, hence these techniques are considered to be cost-effective and well-tolerated for the patients.",
keywords = "Endoscope, Ess, Fistula, Liquor cerebrospinal, Liquorrhoea, Scala anterior",
author = "Zal{\'a}n Piski and A. B{\"u}ki and Nelli Nepp and Andr{\'a}s Buri{\'a}n and P{\'e}ter R{\'e}v{\'e}sz and Imre Gerlinger",
year = "2016",
month = "5",
day = "30",
doi = "10.18071/isz.69.0211",
language = "Hungarian",
volume = "69",
pages = "211--216",
journal = "Ideggyogyaszati Szemle",
issn = "0019-1442",
publisher = "Ifjusagi Lap-es Konyvkiado Vallalat",
number = "5-6",

}

TY - JOUR

T1 - Nasocranialis fistulák zárása "káddugó" technikával és többrétegu rekonstrukcióval

AU - Piski, Zalán

AU - Büki, A.

AU - Nepp, Nelli

AU - Burián, András

AU - Révész, Péter

AU - Gerlinger, Imre

PY - 2016/5/30

Y1 - 2016/5/30

N2 - Background and purpose: In case of dehiscenses developing on the anterior scull base, complete closure resulting in the cessation of the communication between the nasal cavity and the intracranial space is mandatory as soon as possible, in order to prevent serious complications. With the development of the endoscopic techniques, the endonasal management for the reconstruction has become available in recent decades. Methods: We aim to present the reconstruction techniques applied in our department in the cases of two patients recently operated at our institute. The choice of methods primarily depends on the size and the localization of the defect. Dehiscenses under 5 mm of diameter can be closed with the so called "bath-plug" technique, while bigger defects, where the required closure of the plug is not possible, can be solved with multilayer reconstruction. We use autogenous fascia, fat and muco-periosteum in both cases. Results: Our patient, who underwent the aforementioned "bath-plug" procedure, could be discharged after a few days of uneventful postoperative period. During a tenmonth follow-up period new fistula formation was not observed. In the case of a patient who underwent multilayer reconstruction, meningitis occurred postoperatively, which was resolved after antibiotic therapy. During a 17-month follow-up period recurrent liquorrhoea did not occur. Conclusion: With suitable technical background and appropriate endoscopic skills the surgeries of the anterior skull base cerebrospinal fluid fistulas can be performed efficiently and with low complication rate. These are minimally invasive procedures accompanied by less surgical trauma, morbidity and shorter hospitalization, hence these techniques are considered to be cost-effective and well-tolerated for the patients.

AB - Background and purpose: In case of dehiscenses developing on the anterior scull base, complete closure resulting in the cessation of the communication between the nasal cavity and the intracranial space is mandatory as soon as possible, in order to prevent serious complications. With the development of the endoscopic techniques, the endonasal management for the reconstruction has become available in recent decades. Methods: We aim to present the reconstruction techniques applied in our department in the cases of two patients recently operated at our institute. The choice of methods primarily depends on the size and the localization of the defect. Dehiscenses under 5 mm of diameter can be closed with the so called "bath-plug" technique, while bigger defects, where the required closure of the plug is not possible, can be solved with multilayer reconstruction. We use autogenous fascia, fat and muco-periosteum in both cases. Results: Our patient, who underwent the aforementioned "bath-plug" procedure, could be discharged after a few days of uneventful postoperative period. During a tenmonth follow-up period new fistula formation was not observed. In the case of a patient who underwent multilayer reconstruction, meningitis occurred postoperatively, which was resolved after antibiotic therapy. During a 17-month follow-up period recurrent liquorrhoea did not occur. Conclusion: With suitable technical background and appropriate endoscopic skills the surgeries of the anterior skull base cerebrospinal fluid fistulas can be performed efficiently and with low complication rate. These are minimally invasive procedures accompanied by less surgical trauma, morbidity and shorter hospitalization, hence these techniques are considered to be cost-effective and well-tolerated for the patients.

KW - Endoscope

KW - Ess

KW - Fistula

KW - Liquor cerebrospinal

KW - Liquorrhoea

KW - Scala anterior

UR - http://www.scopus.com/inward/record.url?scp=84976635947&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976635947&partnerID=8YFLogxK

U2 - 10.18071/isz.69.0211

DO - 10.18071/isz.69.0211

M3 - Article

C2 - 27468611

AN - SCOPUS:84976635947

VL - 69

SP - 211

EP - 216

JO - Ideggyogyaszati Szemle

JF - Ideggyogyaszati Szemle

SN - 0019-1442

IS - 5-6

ER -