How I do it? Endoscopic endonasal transpterygoid repair of sphenoid lateral recess cerebrospinal fluid leak after previous unsuccessful transcranial surgery

Ming Shen; Xuefei Shou; Yongfei Wang

doi:10.1007/s00701-023-05820-2

How I do it? Endoscopic endonasal transpterygoid repair of sphenoid lateral recess cerebrospinal fluid leak after previous unsuccessful transcranial surgery

Acta Neurochir (Wien). 2023 Dec;165(12):4125-4129. doi: 10.1007/s00701-023-05820-2. Epub 2023 Oct 18.

Authors

Ming Shen^{1

2

3

4

5

6

7}, Xuefei Shou^{1

2

3

4

5

6

7}, Yongfei Wang^{8

9

10

11

12

13

14}

Affiliations

¹ Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
² Neurosurgical Institute of Fudan University, Shanghai, 200040, China.
³ Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China.
⁴ Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China.
⁵ Shanghai Pituitary Tumor Center, Shanghai, 200040, China.
⁶ National Center for Neurological Disorders, Shanghai, China.
⁷ Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences, Beijing, China.
⁸ Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China. eamns@hotmail.com.
⁹ Neurosurgical Institute of Fudan University, Shanghai, 200040, China. eamns@hotmail.com.
¹⁰ Shanghai Clinical Medical Center of Neurosurgery, Shanghai, 200040, China. eamns@hotmail.com.
¹¹ Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China. eamns@hotmail.com.
¹² Shanghai Pituitary Tumor Center, Shanghai, 200040, China. eamns@hotmail.com.
¹³ National Center for Neurological Disorders, Shanghai, China. eamns@hotmail.com.
¹⁴ Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences, Beijing, China. eamns@hotmail.com.

PMID: 37851167
DOI: 10.1007/s00701-023-05820-2

Abstract

Background: Direct access to the sphenoid lateral recess offers the best chance of sealing spontaneous cerebrospinal fluid (CSF) rhinorrhea caused by lateral sphenoid encephaloceles of the Sternberg canal defect.

Method: We present a case of spontaneous left-sided sphenoid lateral recess CSF leak after previous unsuccessful transcranial surgery managed with an endoscopic endonasal transpterygoid approach (EETA). An anatomical-based step-by-step illustration of the EETA was presented in the surgical video.

Conclusion: This case demonstrates the value of endoscopic endonasal transpterygoid corridor in the exposure and manipulation of the sphenoid lateral recess.

Keywords: Cerebrospinal fluid rhinorrhea; Encephalocele; Endoscopic endonasal transpterygoid approach; Sphenoid lateral recess; Sternberg canal.

Publication types

Case Reports

MeSH terms

Cerebrospinal Fluid Leak / diagnostic imaging
Cerebrospinal Fluid Leak / etiology
Cerebrospinal Fluid Leak / surgery
Cerebrospinal Fluid Rhinorrhea* / diagnostic imaging
Cerebrospinal Fluid Rhinorrhea* / etiology
Cerebrospinal Fluid Rhinorrhea* / surgery
Encephalocele / complications
Encephalocele / diagnostic imaging
Encephalocele / surgery
Endoscopy / adverse effects
Humans
Sphenoid Bone / surgery
Sphenoid Sinus* / diagnostic imaging
Sphenoid Sinus* / surgery

Grants and funding

2019-I2M-5-008/Chinese Academy of Medical Sciences