Hostname: page-component-84c44f86f4-lgfmk Total loading time: 0 Render date: 2025-10-14T19:04:02.924Z Has data issue: false hasContentIssue false
  • English
  • Français

Endoscopic modified Lothrop procedure for repair of lateral frontal sinus cerebrospinal fluid leak

Published online by Cambridge University Press:  17 April 2008

J K Anverali ,
A A Hassaan  and
H A Saleh
J K Anverali
Affiliation:
ENT Department, Charing Cross Hospital, London, UK
A A Hassaan*
Affiliation:
ENT Department, Charing Cross Hospital, London, UK
H A Saleh
Affiliation:
ENT Department, Charing Cross Hospital, London, UK
*
Address for correspondence: Mr Amro A Hassaan, 10 St Stephens Avenue, St Albans AL3 4AD, UK. Fax: 01727 850522 E-mail: amrohassaan@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To describe a previously unreported case of repair of a lateral frontal sinus cerebrospinal fluid leak, using the endoscopic modified Lothrop procedure.

Method:

Case report of new technique, with reference to the world literature.

Results:

An effective endoscopic, transnasal repair of a lateral frontal sinus cerebrospinal fluid leak was achieved in a 60-year-old man. The defect was closed with fat, fascia lata and free mucosal grafts. The left nasal cavity was packed and a lumbar drain left in situ post-operatively. The drain and packs were removed one week later and the patient discharged with no complications, and no recurrence at 12 months' follow up.

Conclusion:

Such cerebrospinal fluid leaks have traditionally been repaired using an external approach with osteoplastic flaps and obliteration of the sinus. We highlight the endoscopic modified Lothrop technique as an effective alternative approach to repair of cerebrospinal fluid leaks in poorly accessible areas of the frontal sinus.

Keywords

Frontal SinusCerebrospinal FluidOtorhinolaryngologic Surgical Procedures

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 1 , January 2009 , pp. 145 - 147
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Presented at the 132nd Semon Club, 17 November 2006, Guy's Hospital, London, and at the British Skull Base Society Meeting, 25–26 January 2007, The Belfry, Birmingham, UK.

References

1 Woodworth, BA, Schlosser, RJ, Palmer, JN. Endoscopic repair of frontal sinus cerebrospinal fluid leaks. J Laryngol Otol 2005;119:709–713CrossRefGoogle ScholarPubMed
2 Marshall, AH, Jones, NS, Robertson, IJA. CSF rhinorrhoea: the place of endoscopic sinus surgery. Br J Neurosurg 2001;15:8–12Google ScholarPubMed
3 Ulualp, SO, Carlson, TK, Toohill, RJ. Osteoplastic flap versus modified endoscopic Lothrop procedure in patients with frontal sinus disease. Am J Rhinol 2000;14:21–6CrossRefGoogle ScholarPubMed
4 Draf, W. Endonasal micro-endoscopic frontal sinus surgery: the Fulda concept. Op Tech Otolaryngol Head Neck Surg 1991;2:234–40CrossRefGoogle Scholar
5 Gross, WE, Gross, CW, Becker, D, Moore, D, Phillips, D. Modified transnasal endoscopic Lothrop procedure as an alternative to frontal sinus obliteration. Otolaryngol Head Neck Surg 1995;113:427–34CrossRefGoogle ScholarPubMed
6 Sonnenburg, RE, Senior, BA. Revision endoscopic frontal sinus surgery. Curr Opin Otolaryngol Head Neck Surg 2004;12:49–52CrossRefGoogle ScholarPubMed
7 Carrau, RL, Snyderman, CH, Kassam, AB. The management of cerebrospinal fluid leaks in patients at risk for high-pressure hydrocephalus. Laryngoscope 2005;115:205–12CrossRefGoogle ScholarPubMed
8 Lindstrom, D, Toohill, R, Loehrl, T, Smith, T. Management of cerebrospinal fluid rinorrhoea: the Medical College of Wisconsin experience. Laryngoscope 2004;114:969–74CrossRefGoogle Scholar
9 Mirza, S, Thaper, A, McClelland, L, Jones, NS. Sinonasal cerebrospinal fluid leaks: management of 97 patients over 10 years. Laryngoscope 2005;115:1774–7CrossRefGoogle ScholarPubMed
10 Hegazy, HM, Carrau, RL, Snyderman, CH, Kassam, A, Zweig, J. Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a meta-analysis. Laryngoscope 2000;110:1166–72CrossRefGoogle ScholarPubMed
11 Chatrath, P, Saleh, HA. Endoscopic repair of cerebrospinal fluid rhinorrhoea using bone pate. Laryngoscope 2006;116:1050–3CrossRefGoogle ScholarPubMed