Spontaneous CSF-leaks and XXXX in sphenoid sinus by persisting Sternberg's canal.

@entity1 @entity3976 @entity9
OBJECTIVES: Cerebrospinal fluid (CSF) leaks and @entity3976 of the lateral recess of sphenoid sinuses are rare findings. A congenital bony defect in the lateral wall of sphenoid sinus called Sternberg's canal could be the origin of these lesions. Their endoscopic transnasal management is challenging though less traumatic than transcranial approaches. The aim of this study was to define Sternberg's canal as a potential source for these rare lesions and to describe their endoscopic endonasal management. METHODS: In a retrospective analysis clinical charts of 27 @entity1 with CSF-leaks and / or @entity3976 operated between March 2002 and October 2008 at the University ENT-hospital Graz have been reviewed. All @entity1 were treated by an endoscopic endonasal approach. RESULTS: Five @entity1 (4 female / 1 male) were identified with spontaneous CSF-leaks from sphenoid sinus and @entity3976 . In all five cases, Sternberg's canal was the site of leakage, with the bony and dural defects always located laterally between the @entity9 . Mean age was 51.2 years and mean body mass index (BMI) was 31.9 kg/m2. All @entity1 were operated using a multilayer closure technique. Two @entity1 had recurrences after 12 days and 7 months, respectively, managed by endoscopic revision surgery resulting in a 100% closure rate after one revision (mean follow-up: 6.5 months). CONCLUSION: Persisting Sternberg's canal can be the source of spontaneous CSF-leaks and @entity3976 in the lateral recess of sphenoid sinus especially when associated with extensive pneumatisation. Endoscopic management is technically challenging, nevertheless its advantages are a good view of the surgical field while being less traumatic than transcranial approaches.
