Cerebrospinal fluid rhinorrhoea as a complication of endoscopic endonasal reduction of blowout fractures

J Laryngol Otol. 2012 Sep;126(9):942-5. doi: 10.1017/S0022215112001399. Epub 2012 Jul 12.

Abstract

Background: Unless the orbital contents are supported, the insertion of nasal packing material during endoscopic endonasal surgery may cause serious intracranial complications such as cerebrospinal fluid leakage.

Methods: Case report and literature review.

Results: We report a patient with iatrogenic cerebrospinal fluid rhinorrhoea caused by intracranial entry of a Silastic sheet inserted into the nasal cavity. This skull defect and the surrounding skull base were successfully reconstructed in a multilayer fashion via an endoscopic endonasal approach.

Conclusion: This case highlights the need for caution when inserting nasal packing material. During endoscopic endonasal reduction of blowout fractures, great care must be taken to support the orbital contents, in order to avoid serious intracranial complications such as cerebrospinal fluid leakage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cerebrospinal Fluid Rhinorrhea / diagnostic imaging
  • Cerebrospinal Fluid Rhinorrhea / etiology*
  • Cerebrospinal Fluid Rhinorrhea / surgery
  • Clinical Competence
  • Device Removal
  • Dimethylpolysiloxanes / adverse effects
  • Endoscopy / adverse effects*
  • Ethmoid Bone / injuries
  • Ethmoid Bone / surgery
  • Hemostatic Techniques / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Nasal Cartilages / transplantation
  • Orbital Fractures / surgery*
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Radiography
  • Tampons, Surgical / adverse effects

Substances

  • Dimethylpolysiloxanes
  • baysilon