Sunday, November 21, 2021

Management of cerebrospinal fluid leak in the lateral recess of the sphenoid sinus with transpterygoid approach: A case report

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Int J Surg Case Rep. 2021 Nov 12;89:106594. doi: 10.1016/j.ijscr.2021.106594. Online ahead of print.

ABSTRACT

BACKGROUND: Cerebrospinal fluid (CSF) leak that occurred in the lateral sphenoid sinus is a rare and difficult case. This paper aims to report a case of defect closure in the lateral recess of the sphenoid sinus endoscopically with a transpterygoid approach.

CASE PRESENTATION: A 38-year-old Indonesian woman reported a CSF leak, and identified a defect in the lateral recess of the left sphenoid sinus. CSF leak was repaired with endoscopic transethmoid-pterygoid or transpterygoid endoscopic surgery and no CSF leak was found. The surgical procedure was successful even though it was only performed by an otorhinolaryngologist.

DISCUSSION: Endoscopic transethmoid-pterygoid or transpterygoid endoscopic surgery is effective in repairing defects in the lateral recess of the sphenoid sinus in which surgical procedure is performed by a single otorhinolaryngologist.

CONCLUSION: Endoscopic transpterygoid approach gained access to lateral site of sphenoid sinus was an effective approach in managing CSF leak of lateral sphenoid recess. Closure of the defect using a bone graft and mucosa of the middle turbinate was proven to be effective. It had been carried out successfully in Indonesia.

PMID:34794074 | DOI:10.1016/j.ijscr.2021.106594

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