CSF Leak Repair

The brain is fully encased inside a lining called dura. The brain and the dura are positioned partly above the nose and the sinuses that are separated from them by a thin bone. Any perforation in the bone and the dura can leak the CSF(cerebrospinal fluid) straight into the nasal or the throat cavities.

CSF leakage can occur due to a head injury, complication from sinus or brain injury or due to tumour removal from inside a sinus. The CSF leak becomes visible when clear fluid starts draining from the nose (usually from one nostril) or into the back of the throat (tastes salty).

Conditions treated

CSF Leakage

Why this surgery?

While a CSF leak in itself is a perilous condition, there is also the added risk of an intracranial (within the skull) infection.
The sinuses are high on infection-causing microbes. When the leakage point takes CSF into sinuses, it may also pass on some of these microbes into the CSF space which can then infect the brain and the tissue around.

Benefits

Prevents infection of the brain and surrounding tissues.

Know more about CSF Leak Repair

Pre-Surgery Preparations

Prior to the surgery the patient will have to take the several prescribed medicines that will help reduce inflammation.
The patient will have to abstain from smoking, 3-4 weeks prior to the surgery.
If the patient is on any blood-thinning medications such as aspirin, ibuprofen, omega 3 and/or vitamin E, they should stop their intake at least two weeks prior to the surgery.

Post Surgery Preparations

Patient should sleep with head slightly elevated for 7 days.
No heavy lifting, bending over, or straining for 30 days.
Do not blow nose or sniff forcefully.
Sneeze with mouth open if possible.
Wipe nose gently
Pain medication is to be taken after surgery.
It is normal to have mild bloody drainage for the first 24 to 72 hours.
The patient must use the prescribed nasal sprays as instructed by the doctor.
Patients can go home few hours after surgery

Follow-ups

Potential Complications

The potential risks of this surgery are similar to endoscopic sinus surgery risks wherein there is less than 1% risk of unexpected damage to the brain and the optic nerve.
There is also some risk that the leakage can recur.

Why Dr Rao’s ENT?

Best Success Rate – In contrast to the high-risk brain-side CSF repair that has a 25% failure rate, the endoscopic CSF leak repair is comparatively much more successful with just 10% failure rate. In other words, where a brain-side CSF repair is likely to deliver unsatisfactory results in 1 out of every 4 cases, an equivalent endoscopic repair work is likely to be successful for 9 patients out of every 10.

Facilities Available

World Class Technology

Medtronic IPC with standby Medtronic XPS 3000 (USA)-
Used for CSF rhinorrhea.
Reduces recurrence to 0.1%
Delivers reproducible accuracy for superior precision
Automated registration / verification, reusable instruments, multi-instrument tracking, and surgeon specific settings
Storz Image 1 HD endoscope camera system (GERMANY)-
The one chip endoscope cameras are used for nasal endoscopy.
With 1,920 x 1,080 resolution and progressive scan, the camera control unit (CCU) guarantees a lag-free image and natural colour reproduction.