Endoscopic repair of a meningocele arising from the lateral recess of the sphenoid sinus
by Kailash Sant T

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates the endoscopic management of a CSF leak arising from the lateral recess of the sphenoid sinus. The key points for a successful outcome are a wide exposure, complete removal of the surrounding sphenoid sinus mucosa, cauterizing the prolapsed dura, and plugging the dural defect. While exposing the lateral recess of the sphenoid sinus, one will encounter branches and sometimes even the main trunk of the sphenopalatine artery, and one must be prepared to tackle it. While some prefer to preventively clip or cauterize it, others tackle it as and when the situation arises. Another important aspect is that all the surrounding mucosa of the lateral recess must be denuded so as to ensure that the repair and graft adhere to bare bone. The use of the graft material as well as the use of fibrin glue is a matter of personal preference, but adhering to the above principles is vital to ensure a successful outcome, whatever the technique used.

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