The entire procedure is done through the nostrils and does not require any external incisions. Once the location of the leak has been found, the surgeon will use cartilage and other tissue from inside the nose to repair the area. Images obtained from the endoscope help the surgeon to identify the location of the bony defect causing the leak. An endoscope - a long, thin flexible tube with a tiny camera and light attached at the end - will be inserted through the nostril. Usually done under general anesthesia, CSF leaks through the nose will be repaired using minimally invasive endoscopic techniques. If the source of the CSF leak is through the nose, the repair will be performed by a UH rhinologist - an ENT subspecialist with advanced fellowship training in the medical and surgical treatment of nasal and sinus disorders. Surgical Repair of CSF Leaks through the Nose The contrast solution then enters the brain fluid space and can be seen exiting the nose or ear. If the location of leakage is still unclear after CT and/or MRI, there are additional imaging studies that can be done in which contrast is injected into the back. If there is a concern that a portion of the brain or lining of the brain is entering the sinuses an MRI would also be obtained to better visualize the soft tissue anatomy. Often, a CT will be the first scan performed because it provides excellent, high resolution images of the bony anatomy of the skull base and can help locate the site of leakage. Imaging tests: If a CSF leak is strongly suspected or confirmed, imaging tests will be ordered. This is a critical step to determine whether or not your nasal or ear drainage is something that can be treated medically or if it requires surgical intervention. In addition to evaluating each patient’s symptoms and medical history, our doctors may use the following techniques and tests to confirm a diagnosis of CSF leak:īeta 2 transferrin: A sample of the fluid is collected and tested to determine whether or not the fluid is CSF. The ENT experts at University Hospitals have the experience to recognize and diagnose CSF leaks so that the appropriate treatment plan can be developed. UH Skull Base Specialists Have the Expertise to DiagnoseĪn early and accurate diagnosis of a CSF leak is essential for an optimal treatment outcome and can help prevent infectious complications. Surgery on or around the base of the skull.If left untreated, meningitis can be fatal.Īnyone who has any of the symptoms listed above should be evaluated by an ear, nose and throat specialist, particularly if they have recently experienced any of the following: If left untreated, an individual can develop meningitis which is an infectious process that causes inflammation of the lining of the brain. This issue is taken seriously because there is a direct pathway between the nose or ear and the brain. If a tube is placed into the ear, the drainage will persist because of the amount of brain fluid that is made each day. CSF leaks into the ear most commonly present as middle ear fluid resulting in hearing loss. Individuals may also report a salty or metallic taste in the back of their throat. Common Symptoms of a Cerebrospinal Fluid (CSF) LeakĬSF leaks from the nose most often present as clear, one-sided, persistent nasal drainage that is often worsened with bending forward or straining of any type.
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