Objective: To summary the preliminary experience of fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base cerebrospinal fluid rhinorrhea (CSF) and meningoencephalocele.
Method: Using fat bath-plug technique repair 1 case meningoencephalocele (traumatic) and 5 cases cerebrospinal fluid rhinorrhea (1 traumatic, 4 spontaneous). The analysis index included: preoperative localization, intraoperative position, surgical procedures, perioperative symptoms, follow-up. etc.
Result: CT and MRI techniques were used for location of the fistula preoperative. The location of the fistulas were exploration during the operation and were consist with the imaging studies. All 6 fistulas were repaired during the first operation. No fever and no intracranial infection occurred postoperatively. All the patients discharged 7 days postoperatively with an iodoform nasal packing. Three to 4 weeks later the patients were reviewed to clean up the nasal cavity. All patients were recovered well with good epithelial mucosa in the 3 and 6 months endoscopic follow-ups. No CSF leak and intracranial infection happened in the 3-year telephone follow-up.
Conclusion: The fat bath-plug technique in endoscopic transnasal approach for repairing anterior skull base small fistula, especially in cribriform ethmoid roof, is effective, safe and simple.