A cerebrospinal fluid (CSF) leak repair is a procedure performed on patients experiencing a CSF leak in either their nose or ear. Often, patients experiencing this type of leak will notice a clear drip draining from their nose or ear on one side, that may worsen when tilting or leaning forward.
Cerebrospinal fluid is the mixture of water and electrolytes that circulates the brain and spine. The fluid is important in the immunological and mechanical protection of these structures. Both head trauma and heightened intracranial pressure can cause CSF leaks. They are also very dangerous as they can cause meningitis. This is why it is important to diagnose and treat them as soon as they occur.
We can treat a small cerebrospinal fluid leak by placing a lumbar spinal drain to decrease the intracranial pressure. If this works, the CSF leak will spontaneously resolve. We may suggest surgery for patients who don’t experience relief after a lumbar drain.
Before a CSF leak repair is performed surgically, a rhinologist determines the location of the leak by injecting a dye into the CSF space. The dye turns the CSF into a yellow/green color. Once we determine the location of the CSF leak, a rhinologist can close the leak by performing a highly-specialized surgical CSF leak repair.
A CSF leak can either be repaired from the brain or sinus side of the skull. Our team of sinus surgeons are specialized in sinus CSF repairs, which tend to have a higher success rate than those repaired on the brain side. Our surgeons perform a CSF leak repair through the nasal cavity using an endoscope. Most often, this procedure does not require a facial incision. Though in some cases where the leak is located directly above the eyes, a small incision is required.
Once the defect is located, the surgeon removes the mucosa (nasal and sinus lining) to allow an unobstructed view of the defect. Depending on the size of the repair, the surgeon then places one or more layers of support to plug the defect. Once the surgeon confirms that the support has stopped the CSF leak, he or she will add packing and sealants to further help the repair.
Depending on the patient, our surgeons may place a lumbar drain after surgery to run the CSF fluid away from the repair site in order to reduce pressure. We recommend bed rest for up to a week after the repair. Fortunately, the success rate of endoscopic nasal CSF leak repairs range above 90%.
My Houston Surgeons has fellowship trained sinus specialists on their team, ready to treat conditions like CSF Leaks. Our team is highly trained in a wide variety surgical treatments concerning sinus and nasal disorders, so you can rest assured that your treatment will be the one best suited for your health and full recovery.
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