ISSN: 1859 - 2872
Endoscopic transpterygoid approach for the management of cerebrospinal fluid leakage in the lateral recess of the sphenoid sinus at the Vietnam National Otolaryngology Hospital: A case series
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Abstract
Objective: To report a case series of cerebrospinal fluid (CSF) rhinorrhea originating from the lateral recess of the sphenoid sinus, managed via an endoscopic transpterygoid approach at the Vietnam National Otolaryngology Hospital. Subject and method: A case series study was conducted. Result: All three patients demonstrated extensive pneumatization involving both the greater wing and the pterygoid process of the sphenoid bone. An endoscopic transpterygoid approach was employed to access the defect site. Multilayer reconstruction was performed using fascia lata, cartilage graft, and a nasoseptal flap, reinforced with biological glue and stabilized with Surgicel and nasal Merocel packing. Postoperative management followed the standard protocol for endoscopic repair of CSF rhinorrhea. All three cases achieved successful closure without complications or sequelae, and no recurrence was observed during a follow-up period of 15 - 18 months. Conclusion: The endoscopic transpterygoid approach is a safe and feasible technique for the management of CSF rhinorrhea arising from the lateral recess of the sphenoid sinus. This technique has been successfully implemented at the Vietnam National Otolaryngology Hospital.
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