Repair of Cerebrospinal Fluid Fistula From an Invasive Skull Base Prolactinoma Using a Septal Mucosal Vascularized Flap: Technical Case Report

Department

neurosurgery

Document Type

Article

Abstract

Repair of spontaneous cerebrospinal fluid (CSF) fistulas in patients with invasive skull base prolactinomas represents a surgical challenge because of the many sites of potential leak around the tumor and the possibility of developing additional sites of leak as the tumor regresses on dopamine agonist therapy. Little has been published on effective methods for treating this problem. In this case, a vascularized nasoseptal flap was used to repair a spontaneous CSF leak in a 31-year-old male with an invasive prolactinoma who was commenced on dopamine agonist therapy. The patient underwent successful multilayer repair of the fistula with a nasoseptal vascularized flap and abdominal rectus fascia. After 3 months of follow-up, he has had no CSF leak. CSF fistulas caused by skull base prolactinomas can be repaired successfully using a vascularized nasoseptal flap. Long-term follow-up will determine the durability of this repair technique. © 2013 Georg Thieme Verlag KG.

Publication Date

2013

Publication Title

Journal of Neurological Surgery, Part A: Central European Neurosurgery

ISSN

2193-6315

Volume

74

Issue

1

First Page

e50

Last Page

e53

Digital Object Identifier (DOI)

10.1055/s-0032-1331386

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