Аннотация:Abstract
Objective: The incidence of defects occurence in sphenoid sinus is 15-26%. Within the sphenoid sinus, the most common localization of the
defects are lateral recesses - 35.3%. No matter what is the etiology and pathogenesis of the cerebrospinal fluid leak in the lateral recess of the
sphenoid sinus, the treatment strategy is reconstruction of the complex skull base. Due to the complex anatomical location and the inability
approach the defect directly, surgeries in this area have a high percentage of relapses (25%).
Methods: A retrospective review of a group of 89 patients with nasal cerebrospinal fluid leak from lateral recesses of sphenoid sinus who
were treated in our neurosurgical center between the years of 2001 and 2017. The demographic characteristics of the patients, clinical data
and surgical treatment aspects were taken into account. Treatment results, including the relapse rate and postoperative complications, were
analyzed.
Results: 89 patients (74%) underwent transsphenoidal approach surgery. The number of relapses in this group was 25 (28%), 9 patients (7%)
underwent reconstruction of a complex skull base defect with the use of transethmoidal approach, the number of relapses was 3 (33%). A
transpterygoid approach to the lateral sphenoid recess was used with 22 patients (17%), the number of relapses in this group was 3 (14%).
Conclusion: Transpterygoid approach is advisable to perform in cases of excessive pneumatization and with recurrences of nasal CSF leak.
This allows one to visualize the edges of the defect in this hard-to-reach area and carry on an adequate reconstruction