PMID- 31039072
OWN - NLM
STAT- MEDLINE
DCOM- 20200130
LR  - 20200130
IS  - 1097-6817 (Electronic)
IS  - 0194-5998 (Linking)
VI  - 161
IP  - 3
DP  - 2019 Sep
TI  - Middle Turbinate Friendly Technique for Cribriform Cerebrospinal Fluid Leak 
      Repair.
PG  - 522-528
LID - 10.1177/0194599819847944 [doi]
AB  - OBJECTIVE: To compare surgical outcomes between 2 techniques for cribriform 
      cerebrospinal fluid leak (CSF) repair with middle turbinate preservation (MTP) vs 
      middle turbinate resection (MTR). A secondary outcome is to examine the 
      effectiveness of collagen dura matrix (CDM) as a grafting material for repair of 
      isolated cribriform skull base defects. STUDY DESIGN: A retrospective chart 
      review was performed of consecutive patients who underwent cribriform CSF repair 
      at Emory University over the past 15 years. SETTING: Tertiary care rhinology 
      practice. SUBJECTS: Adult patients with cribriform defects limited to the 
      cribriform plate that did not extend lateral to the middle turbinate (MT) and 
      were reconstructed with a free graft (mucosal or synthetic). METHODS: Patients 
      were stratified into 2 primary groups by surgical technique: MTP vs MTR. A subset 
      of patients underwent repair with CDM alone and was analyzed separately for CSF 
      repair failure rate. RESULTS: Of 68 patients identified with cribriform defects, 
      42 underwent repair with MTP and 26 underwent repair with MTR. Average follow-up 
      time was 495 days. Patients with idiopathic intracranial hypertension were also 
      equally distributed (P = .20). Primary CSF leak repair success was 95.6%, with 
      100% of leaks ultimately repaired. A subset of 39 patients underwent repair with 
      CDM alone, with a primary repair success rate of 94.9%. CONCLUSIONS: We present 
      an effective method for repair of cribriform CSF leaks while preserving the MT. 
      CDM can be successfully used as a free graft alone for repair of isolated 
      cribriform CSF leaks.
FAU - Luk, Lauren J
AU  - Luk LJ
AD  - 1 Orange County Sinus Institute, Southern California Permanente Medical Group, 
      Irvine, California, USA.
FAU - Ikeda, Allison
AU  - Ikeda A
AD  - 2 Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, 
      Georgia, USA.
FAU - Wise, Sarah K
AU  - Wise SK
AD  - 2 Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, 
      Georgia, USA.
FAU - DelGaudio, John M
AU  - DelGaudio JM
AD  - 2 Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, 
      Georgia, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20190430
PL  - England
TA  - Otolaryngol Head Neck Surg
JT  - Otolaryngology--head and neck surgery : official journal of American Academy of 
      Otolaryngology-Head and Neck Surgery
JID - 8508176
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cerebrospinal Fluid Leak/*surgery
MH  - Ethmoid Bone
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Turbinates/*surgery
MH  - Young Adult
OTO - NOTNLM
OT  - CSF leak
OT  - cerebrospinal fluid leak repair
OT  - collagen dura matrix
OT  - cribriform
OT  - idiopathic intracranial hypertension
OT  - middle turbinate preservation
OT  - mucosal graft
EDAT- 2019/05/01 06:00
MHDA- 2020/01/31 06:00
CRDT- 2019/05/01 06:00
PHST- 2019/05/01 06:00 [pubmed]
PHST- 2020/01/31 06:00 [medline]
PHST- 2019/05/01 06:00 [entrez]
AID - 10.1177/0194599819847944 [doi]
PST - ppublish
SO  - Otolaryngol Head Neck Surg. 2019 Sep;161(3):522-528. doi: 
      10.1177/0194599819847944. Epub 2019 Apr 30.