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Double seal technique to obliterate the eustachian tube orifice: a novel method for the treatment of recalcitrant cerebrospinal fluid leak

Published online by Cambridge University Press:  25 August 2015

A S Taghi ,
M Bentley ,
R Kuchai  and
H A Saleh
A S Taghi*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, London Imperial College Healthcare NHS Trust, UK
M Bentley
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, London Imperial College Healthcare NHS Trust, UK
R Kuchai
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, London Imperial College Healthcare NHS Trust, UK
H A Saleh
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, London Imperial College Healthcare NHS Trust, UK
*
Address for correspondence: Mr Ali S Taghi, Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London W6 8RF, UK E-mail: ali@taghi.org.uk
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Abstract

Objective:

To demonstrate a novel and effective surgical technique for the treatment of refractory cerebrospinal fluid rhinorrhoea after skull base surgery. The novel surgical technique is described and the findings of a review of relevant world English-language publications are reported.

Case report:

A 44-year-old woman, otherwise fit and well, presented with more than a 2-year history of right-sided facial pain. A diagnosis of classical trigeminal neuralgia was made. Surgical treatment was undertaken with a retromastoid suboccipital craniotomy. Post-operatively, the patient showed signs of right-sided cerebrospinal fluid rhinorrhoea which was recalcitrant. In light of a continuous leak and several hospital admissions, a novel technique was performed whereby the eustachian tube orifice was obliterated using an endonasal endoscopic approach. The technique proved to be successful, with no further leakage.

Conclusion:

Endoscopic obliteration of the eustachian tube using a double seal technique is a simple, safe and effective procedure in the treatment of a refractory cerebrospinal fluid leak.

Keywords

CSF RhinorrheaEustachian Tube
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 10 , October 2015 , pp. 1028 - 1031
Copyright
Copyright © JLO (1984) Limited 2015 

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