Show pageBacklinksCite current pageExport to PDFBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. ====== Leaks into sphenoid sinus ====== [[Leak]]s into [[sphenoid sinus]] (including post-[[transsphenoidal surgery]] leak). 1. LP BID or CLD: as long as pressure > 150mm H20 or CSF [[xanthochromia]] a) if leak persists > 3 days: repack sphenoid sinus and pterygoid recesses with fat, muscle, cartilage and/or fascia lata (must reconstruct floor of sella, packing alone is inadequate). Some recommend against muscle since it putrefies and shrinks. Continue LP or CLD for 3–5 days post-op b) if leak persists > 5 days: lumboperitoneal shunt (first R/O obstructive hydrocephalus) 2. more difficult surgical approach: intracranial (intradural) approach to medial aspect of [[middle cranial fossa]] 3. consider transnasal sellar injection of [[fibrin glue]] under [[local anesthesia]] leaks_into_sphenoid_sinus.txt Last modified: 2024/06/07 02:53by 127.0.0.1