Abstract：
BACKGROUND: Rhinorrhea due to lateral skull base cerebrospinal fluid (CSF) leaks can be a challenge to manage. Multiple strategies exist for treating CSF leaks in this region including direct repair, posterior Eustachian tube packing, and CSF diversion. Endonasal closure of the Eustachian tube has been reported using cerclage and mucosal flaps.
METHODS: We present the first reported case of endoscopic autologous fat packing of the Eustachian tube orifice to repair a CSF leak. In this case a 42-year-old woman who underwent middle fossa meningioma resection 20 years ago presented with refractory CSF rhinorrhea despite blind sac closure of the ear canal. This persisted after CSF diversion and only resolved after endoscopic endonasal Eustachian tube closure described herein.
CONCLUSIONS: This technique is simple to perform with minimal risk of morbidity. Eustachian tube orifice fat packing may be particularly useful for patients with refractory CSF rhinorrhea with low CSF pressure.
METHODS: We present the first reported case of endoscopic autologous fat packing of the Eustachian tube orifice to repair a CSF leak. In this case a 42-year-old woman who underwent middle fossa meningioma resection 20 years ago presented with refractory CSF rhinorrhea despite blind sac closure of the ear canal. This persisted after CSF diversion and only resolved after endoscopic endonasal Eustachian tube closure described herein.
CONCLUSIONS: This technique is simple to perform with minimal risk of morbidity. Eustachian tube orifice fat packing may be particularly useful for patients with refractory CSF rhinorrhea with low CSF pressure.
摘要：
背景：由于颅底侧脑脊液（CSF）泄漏引起的鼻漏可能是一个挑战。存在多种治疗该区域CSF泄漏的策略，包括直接修复，咽鼓管后填塞,和脑脊液转移。据报道，使用环扎和粘膜瓣对咽鼓管进行鼻内封闭。
方法：我们报道了首例经内镜自体脂肪填塞咽鼓管口修复脑脊液渗漏的病例。在这种情况下，一名42岁的妇女在20年前接受了中窝脑膜瘤切除术，尽管耳道盲囊闭合，但仍出现难治性CSF鼻漏。这种情况在CSF改道后持续存在，并且仅在本文所述的内窥镜鼻内咽鼓管闭合后才解决。
结论：该技术操作简单，发病风险最小。咽鼓管口脂肪填塞可能对CSF压力低的难治性CSF鼻漏患者特别有用。
方法：我们报道了首例经内镜自体脂肪填塞咽鼓管口修复脑脊液渗漏的病例。在这种情况下，一名42岁的妇女在20年前接受了中窝脑膜瘤切除术，尽管耳道盲囊闭合，但仍出现难治性CSF鼻漏。这种情况在CSF改道后持续存在，并且仅在本文所述的内窥镜鼻内咽鼓管闭合后才解决。
结论：该技术操作简单，发病风险最小。咽鼓管口脂肪填塞可能对CSF压力低的难治性CSF鼻漏患者特别有用。
