Abstract
Endonasal fistula closure was successfully conducted under endoscopy in two patients with cerebrospinal fluid rhinorrhea caused by excision of hypothalamus tumor. Case 1 was a 48-year old male who underwent trans-sphenoidal surgery of the TSH-producing hypothalamus tumor in the neurosurgery dept. of this hospital. He was referred to this unit as cerebrospinal fluid rhinorrhea was suspected because of headache, fever and watery rhinorrhea which occurred about 10 days after the operation. Endonasal fistula closure was conducted under endoscopy as a fistula was detected in the posterior wall of the sphenoid sinus. The fascia with adipose tissue collected from the femoral region and covered with fibrin glue was inserted into the fistula. Gauze was then inserted into the sphenoid sinus for 4 weeks to keep the tissue section in place. After the surgery, the fistula was completely closed. Case 2 was a 30-year old male who underwent trans-sphenoidal surgery of the GHproducing hypothalamus tumor. Endoscopic endonasal fistula closure was conducted as in case 1, since cerebrospinal fluid rhinorrhea occurred about 10 days after surgery. Symptoms disappeared after closure. Endoscopic endonasal fistula closure technique used by us seems to be very effective for cerebrospinal fluid rhinorrhea caused by neurosurgical procedures.
