A Comparative Study of Two Reconstructive Methods to Repair Sternberg’s Canal Cerebrospinal Fluid Leaks

Year 2024, Volume: 7 Issue: 3, 102 - 110, 10.12.2024

Janakiram T N , Mansi a r Venkatramanan Soumya Sampath Arun Kumar G

Abstract

Objective: This study aimed to compare the effectiveness of a vascularized pedicle nasoseptal flap viz. Hadad–
Bassagasteguy flap (HBF) with fat supplementation versus a free graft (fascia lata graft with fat) for repairing cerebro-
spinal fluid (CSF) leaks in the Sternberg’s canal using a transpterygoid transphenoidal approach.

Methods: A retrospective study was performed on 32 patients with Sternberg’s Canal CSF Leak (SCCL) between May
2008 and March 2020. The diagnosis was established using Beta-2-transferrin and imaging—computed tomography
cisternography and magnetic resonance imaging. Postoperative results were analyzed by symptom relief, and mor-
bidity was assessed using a patient questionnaire and diagnostic nasal endoscopy.

Results: This study included 32 patients (19 females and 13 males). Eighteen patients underwent repair with fat, fas-
cia and 14 underwent closure with a nasoseptal flap and fat. The success rate was directly proportional to adequate
visualization, exposure, and proper creation of the bed by extirpating all the mucosa in the lateral recess/sphenoid
sinus, irrespective of the use of vascularized pedicle flaps.

Conclusion: We found that the type of graft material HBF and fat or free grafts (fat with fascia) were both equally
effective in closing the leak. However, postoperative morbidity was higher in cases where nasoseptal flaps were used
for closure.

Keywords

CSF leaks , fascia lata , nasoseptal flap , Sternberg’s canal

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