This comprehensive book is divided into 6 parts that cover all topics related to cerebrospinal fluid (CSF ) rhinorrea. It provides in-depth theoretical and practical knowledge, and includes teaching material as well as evidence-based scientific content.
The introductory part presents the skull base anatomy, CSF physiology, pathophysiology of skull base defects as well as the role of imaging in this condition. The second and third parts provide details of different diagnostic features and conservative management. The fourth and central part thoroughly illustrates surgical approaches for this clinical condition and follows a similar structure, describing each surgical procedure step-by-step. The fifth part sheds light on the postoperative management and the long-term follow up, while the last part addresses miscellaneous topics, such as quality of life, outcome measures, and medico-legal issues.
The book is enriched by a wealth of high-quality figures and online videos that illustrate real-world clinical cases, and each chapter features a summary box, key points and a conclusion. The contributors are leading experts in the field and include authorities and inventors of skull base surgical approaches and reconstruction techniques. The multidisciplinary panel of authors – from 6 continents – consists of neurosurgeons, radiologists and anesthesiologists. The book is intended for medical, surgical and paramedic professionals, and is a valuable resource for all levels – from medical students to consultants.
Inhaltsverzeichnis
1 Skull base development and anatomy.- 2 Imaging of skull base.- 3 Physiology of CSF.- 4 Pathophysiology of skull base defect and CSF leak.- 5 Clinical presentation of CSF leak.- 6 Fluid analysis in rhinorrhea.- 7 Role of radiology in CSF leak.- 8 Use of fluorescein.- 9 Diagnostic algorithm for CSF leak.- 10 Conservative management of CSF leak.- 11 Traumatic CSF leaks.- 12 Spontaneous CSF leaks: Intracranial hypertension, Neoplasms, Idiopathic.- 13 Multidisciplinary approach to CSF leak.- 14 History of surgical approaches and techniques for skull base reconstruction.- 15 Operative room set-up and instrumentation.- 16 Role of anesthesiologist.- 17 Synthetic materials for skull base reconstruction.- 18 Free autologous graft.- 19 Local pedicled flaps.- 20 Regional pedicled flap.- 21 Micro-vascular free flap.- 22 Anterior cranial fossa CSF leak repair.- 23 Middle & Posterior cranial fossa CSF leak repair.- 24 The proper use of reconstructive material.- 25 External approaches for skull base reconstruction.- 26 Post-operative instructions.- 27 Surgical complications of skull base reconstruction.- 28 Failure of CSF leak repair.- 29 Role of lumbar drain in CSF leak.- 30 Long-term follow up strategy.- 31 Pediatric CSF leak.- 32 Outcomes of skull base reconstruction.- 33 Abnormal presentation of CSF leak.- 34 Management of benign intracranial hypertension.- 35 Evidence based medicine in CSF leak and skull base reconstruction.- 36 Quality of life and Outcome measures in CSF leak.- 37 Surgical competence in CSF leak repair.- 38 Patients advocacy and medico-legal issues.
Über den Autor
Abdulaziz Al Qahtani is assistant professor (Adj.) of Otorhinolaryngology at Al Faisal University. He gained his experience after obtaining his clinical Fellowship in Rhinology and Endoscopic Skull Base Surgery at the University of Insubria, Varese-Italy. He is a member of the European Board of ORL/HNS and completed his research scholarship from Harvard Medical School, Boston, MA, USA. He is a consultant at King Fahad Medical City-KFMC, Riyadh as well as the chairman of research advisory board. He is a founder member and board member of the Saudi Skull base Society. He is also a member of the European Rhinologic Society, the European Skull Base Society, the North American Skull Base Society, and the American Rhinologic Society.
Paolo Castelnuovo is a Full Professor, Chairman and Head of the Department of Otorhinolaryngology, University Hospital of Circolo-Varese, Italy, as well as Director and Chairman of the Neurological Surgery and the Surgical Specialties Department at the same university. His main clinical interests are endoscopic sinus and skull base surgery, challenging oncological cases and CSF leak repair. His research interests focus on chronic rhinosinusitis, skull base endoscopic reconstruction, sinonasal and skull base oncology. Since 2012 he has been President of the Italian Academy of Rhinology (IAR). He is also a member of the European Rhinologic Society, the European Skull Base Society, the European Academy of Facial Plastic Surgery and the American Rhinologic Society.
Roy Casiano is Professor of Otolaryngology and Vice Chairman of Clinical Operations, as well as Director of the Rhinology and Endoscopic Skull Vase Program, at the Department of Otolaryngology at the University of Miami, Miller School of Medicine, USA. In 2004 he was appointed at the University of Miami Hospital. He is an attending physician at Jackson Memorial Hospital and University of Miami Hospitaland Clinics, Miami, Florida, USA. He is a member of the American Rhinological Society, American Academy of Otolaryngology Head and Neck Surgery, American College of Surgeons, and Pan American Association of Otolaryngology Head and Neck Surgery. He has served as Associate Editor for the Otolaryngology Head and Neck Journal, and is active on the editorial review boards for a number of peer review journals in Otolaryngology (Laryngoscope, Allergy and Rhinology Journal, International Forum of Allergy and Rhinology, Archives of Otolaryngology, and Otolaryngology Head and Neck Journal).
Ricardo L. Carrau, MD, MBA holds the Lynn Shepard Jones Chair in Head and Neck Oncology at the Department of Otolaryngology – Head & Neck Surgery, is the Director of the Comprehensive Skull Base Surgery program at the Ohio State University Wexner Medical Center, Columbus, USA; and the Associate Dean for Faculty Advancement, Mentoring and Engagement (FAME) for the OSU College of Medicine . He has secondary appointments in the Department of Neurological Surgery as well as in the Department of Speech and Hearing Science. In addition he is the Co-Chair for Destination Medicine Global Health Care and the Co-Director of the Anatomy Laboratory Toward Visuospatial Surgical Innovations in Otolaryngology and Neurosurgery (ALT-VISION) at OSUMC. He is a Fellow of the American College of Surgeons and the American Academy of Otolaryngology – Head & Neck Surgery, past president of the North American Skull Base Society, and member of the American Society for Head and Neck Surgery, the European Skull Base Society, the American Rhinologic Society and the American Laryngology Association