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Endoscopic and fluoroscopic-guided closure of the eustachian tube using a biliary cytology brush and liquid embolic agent for a persistent CSF leak after schwannoma resection.

Sharika BamezaiZachary M WilseckEmily StuckenJoseph J Gemmete
Published in: BMJ case reports (2021)
Vestibular schwannoma is a known cause of progressive sensorineural hearing loss. Treatment options include observation, radiation therapy and surgical resection. Cerebrospinal fluid (CSF) fistula is a known postsurgical complication that can lead to CSF otorrhoea, rhinorrhoea or CSF leakage from the surgical wound. We present a case report of a patient who underwent vestibular schwannoma resection and postoperatively developed CSF rhinorrhoea, which was refractory to multiple attempts at surgical repair. This was successfully treated under endoscopic and fluoroscopic guidance using a biliary cytology brush to disrupt the surface of the eustachian tube followed by injection of n-Butyl cyanoacrylate.
Keyphrases
  • wound healing
  • cerebrospinal fluid
  • ultrasound guided
  • radiation therapy
  • fine needle aspiration
  • squamous cell carcinoma
  • case report
  • ionic liquid
  • hearing loss