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Geert J M G Van Der Heijden - One of the best experts on this subject based on the ideXlab platform.
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no evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent Rhinorrhea a systematic review of the evidence base
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Medard F M Van Den Broek, Corien Gudden, Wouter P Kluijfhout, Manon C Stamslob, Nina M Kaper, Geert J M G Van Der Heijden, Mark C J AartsAbstract:ObjectiveTo evaluate the diagnostic value of symptom duration and purulent Rhinorrhea in adults suspected of having acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Library.Review MethodsWe performed a comprehensive systematic search on March 28, 2013. We included studies on the diagnostic value of duration of symptoms and purulent Rhinorrhea in patients suspected of having acute bacterial rhinosinusitis. We assessed study design of included articles for directness of evidence and risk of bias. We extracted prevalence and positive and negative predictive values.ResultsOf 4173 unique publications, we included 1 study with high directness of evidence and moderate risk of bias. The prior probability of bacterial rhinosinusitis was 0.29 (95% confidence interval [CI], 0.24-0.35); we could not extract posterior probabilities. Odds ratios (95% CI) from univariate analysis were 1.03 (0.78-1.36) for duration of symptoms and 2.69 (1.39-5.18) for colored discharge on the floor of the nasal...
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no evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent Rhinorrhea a systematic review of the evidence base
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Medard F M Van Den Broek, Corien Gudden, Wouter P Kluijfhout, Manon C Stamslob, Nina M Kaper, Geert J M G Van Der Heijden, Mark C J AartsAbstract:ObjectiveTo evaluate the diagnostic value of symptom duration and purulent Rhinorrhea in adults suspected of having acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Libra...
Medard F M Van Den Broek - One of the best experts on this subject based on the ideXlab platform.
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no evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent Rhinorrhea a systematic review of the evidence base
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Medard F M Van Den Broek, Corien Gudden, Wouter P Kluijfhout, Manon C Stamslob, Nina M Kaper, Geert J M G Van Der Heijden, Mark C J AartsAbstract:ObjectiveTo evaluate the diagnostic value of symptom duration and purulent Rhinorrhea in adults suspected of having acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Library.Review MethodsWe performed a comprehensive systematic search on March 28, 2013. We included studies on the diagnostic value of duration of symptoms and purulent Rhinorrhea in patients suspected of having acute bacterial rhinosinusitis. We assessed study design of included articles for directness of evidence and risk of bias. We extracted prevalence and positive and negative predictive values.ResultsOf 4173 unique publications, we included 1 study with high directness of evidence and moderate risk of bias. The prior probability of bacterial rhinosinusitis was 0.29 (95% confidence interval [CI], 0.24-0.35); we could not extract posterior probabilities. Odds ratios (95% CI) from univariate analysis were 1.03 (0.78-1.36) for duration of symptoms and 2.69 (1.39-5.18) for colored discharge on the floor of the nasal...
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no evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent Rhinorrhea a systematic review of the evidence base
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Medard F M Van Den Broek, Corien Gudden, Wouter P Kluijfhout, Manon C Stamslob, Nina M Kaper, Geert J M G Van Der Heijden, Mark C J AartsAbstract:ObjectiveTo evaluate the diagnostic value of symptom duration and purulent Rhinorrhea in adults suspected of having acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Libra...
Pinan Liu - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic transnasal surgery for treatment of cerebrospinal fluid Rhinorrhea
Tianjin Huanhu Hospital, 2019Co-Authors: Zhen Chen, Zhijun Yang, Jian Liu, Pinan LiuAbstract:Objective To explore the feasibility and curative effect of endoscopic transnasal surgery in the treatment of cerebrospinal fluid (CSF) Rhinorrhea. Methods and Results From November 2011 to June 2018, a total of 198 patients with CSF Rhinorrhea underwent endoscopic transnasal surgery in our hospital. There were 191 cases being repaired successfully in the first surgery, and the success rate of primary repair was 96.46% (191/198). Postoperative Rhinorrhea recurred in 7 cases (3.54%, 7/198), and they were repaired successfully in the second surgery. After operation, 14 cases (7.07% ) suffered from intracranial infection, and were cured by antibiotic therapy. One case (0.51%) with deep venous thrombosis of right lower limb and 2 cases (1.01%) with intermuscular venous thrombosis of lower limbs were treated by low molecular heparin anticoagulant therapy. One case (0.51% ) died of septic shock. All survival patients were followed up for (36.27 ± 15.36) months, and none of them relapsed. Conclusions Endoscopic transnasal surgery has a high success rate and less trauma in the repair of CSF Rhinorrhea. Postoperative intracranial infection should be prevented as the main postoperative complication. DOI: 10.3969/j.issn.1672-6731.2019.04.00
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primary spontaneous cerebrospinal fluid Rhinorrhea a symptom of idiopathic intracranial hypertension
Journal of Neurosurgery, 2011Co-Authors: Zhijun Yang, Chungcheng Wang, Bo Wang, Pinan LiuAbstract:Object The authors aim to identify the characteristics of primary spontaneous CSF Rhinorrhea and propose a hypothesis for its pathogenesis. Methods Between 2003 and 2009, 21 patients diagnosed with primary spontaneous CSF Rhinorrhea underwent surgery in the authors' hospital. The clinical aspects were retrospectively reviewed, and their characteristics were analyzed. Results There were 18 women and 3 men, whose ages ranged from 37 to 74 years (mean 53 years). Body mass index (BMI) ranged from 22 to 58.8 kg/m2 (mean 31.2 kg/m2). Eighteen patients (85.7%) were overweight, and 18 (85.7%) suffered from headache or tinnitus before Rhinorrhea. Radiological images revealed fully or partially empty sellae in 14 patients (66.7%). The preoperative intracranial pressure (ICP) ranged from 11 to 28 cm H2O (mean 17.6 cm H2O), while the postoperative ICP ranged from 21 to 32 cm H2O (mean 25.5 cm H2O, p < 0.01). An endoscopeassisted transnasal approach was chosen for the repair. Postoperatively, in 95.2% of patients a cu...
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surgical strategy for cerebrospinal fluid Rhinorrhea repair
Operative Neurosurgery, 2010Co-Authors: Pinan Liu, Bo WangAbstract:OBJECTIVE Cerebrospinal fluid (CSF) Rhinorrhea is leakage of CSF from the nasal cavity caused by cranial base or meningeal defects. Surgical treatment of CSF Rhinorrhea is still problematic. We evaluated the clinical outcomes of 132 consecutive cases of CSF Rhinorrhea treated via transcranial or transnasal endoscopic approaches according to the patient's condition. The indications for the approaches are discussed. METHODS Of 132 patients with CSF Rhinorrhea, a transnasal endoscopic approach was used in 98 to repair cranial base defects in the ethmoid and sphenoid sinuses. A transcranial intradural approach was used in the remaining 34 patients for frontal sinus defects, multiple fractures of the cranial base, or combination nerve injury. RESULTS CSF Rhinorrhea resolved after initial surgery in 124 of 132 patients, giving a success rate of 94%. Of the 8 failures or recurrent cases, 4 were successfully repaired by repeat endoscopic surgery, 2 were cured by transcranial revision surgery, and 2 refused additional surgery (the condition subsequently resolved without treatment in these patients). Postoperative complications included intracranial infection (8 patients) and anosmia (1 patient). No neurological deficits were apparent over the 10-month mean follow-up period. CONCLUSION Transnasal endoscopic repair is a reliable method for CSF Rhinorrhea patients whose fistulae are located in the ethmoid and sphenoid sinuses. The transcranial procedure should be the treatment of choice for patients with frontal sinus fracture, multiple or complex anterior cranial base fractures, or nerve injury. A satisfactory surgical outcome depends on exact diagnosis, proper operative approach, and the surgeon's skill and experience.
Roy R Casiano - One of the best experts on this subject based on the ideXlab platform.
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managing cerebrospinal fluid Rhinorrhea after lateral skull base surgery via endoscopic endonasal eustachian tube closure
American Journal of Rhinology & Allergy, 2015Co-Authors: Lori A Lemonnier, Arjuna B Kuperan, Deya Jourdy, Belachew Tessema, Jacques J Morcos, Fred F Telischi, Roy R CasianoAbstract:BACKGROUND A cerebrospinal fluid (CSF) leak, commonly presenting as Rhinorrhea, is a well-recognized complication of lateral skull base surgery. Failure of conservative treatment measures in these cases necessitates surgical intervention. OBJECTIVE Our aim is to demonstrate that endoscopic endonasal closure of the eustachian tube is a reasonable alternative to more traditional techniques for management of recalcitrant postoperative CSF Rhinorrhea after removal of middle and posterior cranial fossa lesions. METHODS A retrospective chart review was performed for patients who presented with CSF Rhinorrhea after lateral skull base surgery at a tertiary medical center over a 17-year period, from 1997 to 2014. Nine patients managed with endoscopic endonasal closure of the eustachian tube were evaluated for preoperative hearing status, approach to lateral skull base surgery, pathology, size and location of the tumor, timing and presentation of CSF leak, methods of treatment, length of hospital stay, complications, and success of the procedure. RESULTS Of the nine patients included in this review, seven were managed successfully with endoscopic endonasal eustachian tube closure. Of those seven, one required a revision procedure. Average length of postoperative stay was 5.8 days. There were no major complications. Follow up of greater than 100 months has been achieved since the first procedure. CONCLUSION Endoscopic endonasal eustachian tube closure is a safe, minimally invasive and effective method for obliteration of the eustachian tube orifice. The algorithm for management of recalcitrant postoperative CSF Rhinorrhea after lateral skull base surgery should include endoscopic endonasal closure of the eustachian tube.
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managing cerebrospinal fluid Rhinorrhea after lateral skull base surgery via endoscopic endonasal eustachian tube closure
American Journal of Rhinology & Allergy, 2015Co-Authors: Lori A Lemonnier, Arjuna B Kuperan, Deya Jourdy, Belachew Tessema, Jacques J Morcos, Fred F Telischi, Roy R CasianoAbstract:BackgroundA cerebrospinal fluid (CSF) leak, commonly presenting as Rhinorrhea, is a well-recognized complication of lateral skull base surgery. Failure of conservative treatment measures in these cases necessitates surgical intervention.ObjectiveOur aim is to demonstrate that endoscopic endonasal closure of the eustachian tube is a reasonable alternative to more traditional techniques for management of recalcitrant postoperative CSF Rhinorrhea after removal of middle and posterior cranial fossa lesions.MethodsA retrospective chart review was performed for patients who presented with CSF Rhinorrhea after lateral skull base surgery at a tertiary medical center over a 17-year period, from 1997 to 2014. Nine patients managed with endoscopic endonasal closure of the eustachian tube were evaluated for preoperative hearing status, approach to lateral skull base surgery, pathology, size and location of the tumor, timing and presentation of CSF leak, methods of treatment, length of hospital stay, complications, an...
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spontaneous csf Rhinorrhea prevalence of multiple simultaneous skull base defects
American Journal of Rhinology & Allergy, 2015Co-Authors: Seth M Lieberman, Si Chen, Daniel Jethanamest, Roy R CasianoAbstract:BACKGROUND Spontaneous cerebrospinal fluid (CSF) leaks are caused by intracranial hypertension. Given this underlying etiology, patients may be at risk for developing multiple skull base defects. OBJECTIVE The purpose of our study is to present the prevalence of multiple simultaneous skull base defects in patients with spontaneous CSF Rhinorrhea. METHODS We performed a retrospective chart review in a tertiary care practice of 44 consecutive patients with spontaneous CSF Rhinorrhea who underwent endoscopic repair by the senior author (R.R.C.) to determine the prevalence of having multiple simultaneous skull base defects identified at the time of surgery. We defined this as two or more bony defects identified endoscopically with intact intervening bone with or without soft tissue prolapse into the nasal cavity or paranasal sinus cavity. RESULTS Eight of 44 patients (18.2%) were found to have multiple simultaneous skull base defects. The average body mass index (BMI) of the study population was 34.5 (range, 22.7-59). CONCLUSION A significant number of patients with spontaneous CSF Rhinorrhea may have more than one skull base defect present at the time of presentation. The clinical significance of this finding in surgical and medical decision making is not clear at this time.
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endoscopic cerebrospinal fluid Rhinorrhea repair is a lumbar drain necessary
Otolaryngology-Head and Neck Surgery, 1999Co-Authors: Roy R Casiano, David JassirAbstract:OBJECTIVES: To determine the necessity for lumbar drains during endoscopic cerebrospinal fluid (CSF) Rhinorrhea repair.METHODS: Thirty-three patients underwent endoscopic repair of CSF Rhinorrhea without a lumbar drain during a 7-year period. The size of the dural defect ranged from a microleak (less than 1 mm dural defect) to a 3-cm dural defect of the anterior skull base.RESULTS: All of the procedures in patients with smaller defects (<5 mm) were performed on an outpatient basis. Thirty-two patients (97%) had complete resolution of their CSF leak after 1 procedure without any recurrence (average follow-up 29 months).CONCLUSION: A lumbar drain is not routinely necessary for successful closure of CSF Rhinorrhea of any size. Smaller dural defects may be safely performed on an outpatient basis without complications. (Otolaryngol Head Neck Surg 1999;121:745-50.)
Wouter P Kluijfhout - One of the best experts on this subject based on the ideXlab platform.
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no evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent Rhinorrhea a systematic review of the evidence base
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Medard F M Van Den Broek, Corien Gudden, Wouter P Kluijfhout, Manon C Stamslob, Nina M Kaper, Geert J M G Van Der Heijden, Mark C J AartsAbstract:ObjectiveTo evaluate the diagnostic value of symptom duration and purulent Rhinorrhea in adults suspected of having acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Library.Review MethodsWe performed a comprehensive systematic search on March 28, 2013. We included studies on the diagnostic value of duration of symptoms and purulent Rhinorrhea in patients suspected of having acute bacterial rhinosinusitis. We assessed study design of included articles for directness of evidence and risk of bias. We extracted prevalence and positive and negative predictive values.ResultsOf 4173 unique publications, we included 1 study with high directness of evidence and moderate risk of bias. The prior probability of bacterial rhinosinusitis was 0.29 (95% confidence interval [CI], 0.24-0.35); we could not extract posterior probabilities. Odds ratios (95% CI) from univariate analysis were 1.03 (0.78-1.36) for duration of symptoms and 2.69 (1.39-5.18) for colored discharge on the floor of the nasal...
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no evidence for distinguishing bacterial from viral acute rhinosinusitis using symptom duration and purulent Rhinorrhea a systematic review of the evidence base
Otolaryngology-Head and Neck Surgery, 2014Co-Authors: Medard F M Van Den Broek, Corien Gudden, Wouter P Kluijfhout, Manon C Stamslob, Nina M Kaper, Geert J M G Van Der Heijden, Mark C J AartsAbstract:ObjectiveTo evaluate the diagnostic value of symptom duration and purulent Rhinorrhea in adults suspected of having acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Libra...
