Application of the Mimic Valsalva Maneuver with the Help of a Saccule in Cerebrospinal Fluid Rhinorrhea Reconstruction Surgery

ORL J Otorhinolaryngol Relat Spec. 2015;77(6):366-71. doi: 10.1159/000439173. Epub 2015 Oct 21.

Abstract

Objective: To explore the mimic Valsalva maneuver with the help of a saccule handled by an anesthesiologist in order to locate the leakage channel and repair the fistula during intranasal endoscopic reconstruction surgery of cerebrospinal fluid rhinorrhea.

Methods: From 2012 to 2014, 8 patients were diagnosed with cerebrospinal fluid rhinorrhea by medical histories, physical and biochemical examination. All patients were treated with intranasal endoscopic reconstruction surgery of cerebrospinal fluid rhinorrhea. During the surgery, the mimic Valsalva maneuver with the help of a saccule was carried out once or twice by an anesthetist during the operation. Intranasal endoscopy was used to accurately locate the leakage site as shown by the exact fistula. Temporal fascia, fascia lata, middle turbinate mucosa and nasal septum mucosa were all used to repair the fistula.

Results: After the surrounding mucosa was removed, the exact leakage sites were accurately found. Fascia materials were used in all 8 patients. All patients were successfully treated after their first operation, and 1 patient was successfully treated by two operations with no complications and recurrences. All the patients were followed up for 1 month to 2 years.

Conclusion: The convenient method of the mimic Valsalva maneuver with the help of a saccule handled by an anesthesiologist has a good prospect in cerebrospinal fluid rhinorrhea reconstruction surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cerebrospinal Fluid Rhinorrhea / diagnosis
  • Cerebrospinal Fluid Rhinorrhea / physiopathology
  • Cerebrospinal Fluid Rhinorrhea / surgery*
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods*
  • Nose
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Saccule and Utricle / diagnostic imaging*
  • Time Factors
  • Tomography, X-Ray Computed*
  • Valsalva Maneuver / physiology*
  • Young Adult