OBJECTIVE: To analyze possible etiological factors of spontaneous @entity5173 ( @entity5173 ) @entity5254 and to assess the outcomes of endonasal endoscopic repair. DESIGN: Retrospective study. SETTING: Academic neurosurgical hospital. @entity1 Twenty-one consecutive @entity1 who presented with spontaneous @entity5173 leak and underwent endonasal endoscopic surgery from January 1999 through December 2001. INTERVENTION: Preoperative examination included computed tomographic scans; nasal endoscopy; measurement of @entity413 concentration in the nasal discharge; and, in some cases, cisternographic evaluations via computed tomography and/or magnetic resonance imaging. Telescopes, conventional endoscopic sinus surgery instruments, and a microdebrider were used for all @entity1 who underwent endonasal surgery. A combination of plastic materials, ie, abdominal fat, fascia lata, rotated middle turbinate flaps, and fibrin glue, were used for fistula repair. RESULTS: At the time of surgery, @entity5173 @entity292 were found in the cribriform plate (6 @entity1 ), in the fovea ethmoidalis (6 @entity1 ), and in the sphenoid sinus (9 @entity1 ). In 5 of the 6 @entity1 who had an extremely pneumatized sphenoid sinus, the source of the leak was located in the lateral extension of the sinus. A meningocele protruding through the bone defect was the source of the leak in 10 @entity1 . Postoperative follow-up lasted from 9 to 42 months, and 20 @entity1 were considered cured. There was only 1 recurrence, in a @entity1 whose @entity5173 @entity5254 originated in the deep lateral recess of an overpneumatized sphenoid sinus. Thus, the overall success rate was 95.2%. There were no postoperative complications. CONCLUSIONS: Possible etiological factors of this disease include @entity28 , @entity600 of the skull base, an overpneumatized sphenoid sinus (particularly in its lateral extensions), and the @entity4776 . Endoscopic endonasal repair of spontaneous @entity5173 @entity5254 appears to be a safe and successful procedure. However, techniques for endoscopic closure of @entity5173 @entity292 in the lateral part of the sphenoid sinus need further perfecting.

Endonasal endoscopic repair of spontaneous XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obesity'] @entity4776 :: ('MESH:D004652', 'Disease') :: ['empty sella syndrome'] @entity600 :: ('MESH:D000014', 'Disease') :: ['congenital malformations'] @entity5173 :: ('MESH:D065634', 'Disease') :: ['CSF', 'cerebrospinal fluid'] @entity5254 :: ('MESH:D002559', 'Disease') :: ['rhinorrhea'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistulas'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose']
@entity5173 :: (MESH:D065634,Disease) :: ['cerebrospinal fluid leaks']
