Correspondence
Conflict of interest
The authors report no conflict of interests. The authors alone are responsible for the content and writing of the manuscript. References 1 Grant J.R., Arganbright J. & Friedland D.R. (2008) Outcomes for conservative management of traumatic conductive hearing loss. Otol. Neurotol. 29, 344–349 2 Hasso A.N. & Ledington J.A. (1988) Traumatic injuries of the temporal bone. Otolaryngol. Clin. North Am. 21, 295–316 3 Yetiser S., Hidir Y., Birkent H. et al. (2008) Traumatic ossicular dislocations: etiology and management. Am. J. Otolaryngol. 29, 31–36
4 Vincent R., Rovers M., Mistry N. et al. (2011) Ossiculoplasty in intact stapes and malleus patients: a comparison of PORPs versus TORPs with malleus relocation and Silastic banding techniques. Otol. Neurotol. 32, 616–625 5 Babu S. & Seidman M.D. (2004) Ossicular reconstruction using bone cement. Otol. Neurotol. 25, 98–101 6 Maassen M.M. & Zenner H.P. (1998) Tympanoplasty type II with ionomeric cement and titanium-gold-angle prostheses. Am. J. Otol. 19, 693–699 7 Ozer E., Bayazit Y.A., Kanlikama M. et al. (2002) Incudostapedial rebridging ossiculoplasty with bone cement. Otol. Neurotol. 23, 643– 646 8 Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. (1995) American academy of otolaryngology-head and neck surgery. Otolaryngol. Head Neck Surg. 113,186–187. 9 Shabana Y.K., Abu-Samra M. & Ghonim M.R. (2009) Stapes surgery for post-traumatic conductive hearing loss: how we do it. Clin. Otolaryngol. 34, 64–66 10 Schwetschenau E.L. & Isaacson G. (1999) Ossiculoplasty in young children with the Applebaum incudostapedial joint prosthesis. Laryngoscope 109, 1621–1625
A purely synthetic and biodegradable material for repair of cerebrospinal fluid rhinorrhoea Surda, P., Syed, I., Modayil, P.C., Little, S.A. & Toma, A. Department of Otolaryngology, St Georges’ Hospital, London, UK Accepted for publication 24 May 2015
Dear Editor, Cerebrospinal fluid rhinorrhoea is defined as the leakage of cerebrospinal fluid through the nasal cavity due to disruption of barriers between the sinonasal cavity and the anterior and middle cranial fossae. The cerebrospinal fluid leaks are often classified as traumatic or non-traumatic.1 The leak can be found directly after the trauma but also many years later. Most leaks are traumatic, and a small number are iatrogenic.1 The main concern with cerebrospinal fluid rhinorrhoea is the high risk of developing meningitis. There is a cumulative risk of meningitis of around 10% per year, and 85% of patients will have had at least one episode of meningitis over a 20-year period,2 hence the need for a watertight closure of these leaks. Cerebrospinal fluid rhinorrhoea repairs are performed by neurosurgeons and otolaryngologists. The approaches for
Correspondence: A. Toma, ENT Department, St George’s Hospital, Blackshaw Road, London SW17 0QT, UK. Tel.: +44 20 8725 3246; Fax: +44 20 87253306; e-mail: [email protected] © 2015 John Wiley & Sons Ltd Clinical Otolaryngology 41, 176–196
surgical closure include intracranial, transnasal and combined. Endonasal endoscopic closure has become the preferred route for repairing cerebrospinal fluid leaks from anterior skull base as it avoids the need for a craniotomy and associated morbidity.3,4 A recent systematic review of endoscopic repair of cerebrospinal fluid leaks has shown a primary closure rate of 90% and low complication rates of
Conflict of interest
The authors report no conflict of interests. The authors alone are responsible for the content and writing of the manuscript. References 1 Grant J.R., Arganbright J. & Friedland D.R. (2008) Outcomes for conservative management of traumatic conductive hearing loss. Otol. Neurotol. 29, 344–349 2 Hasso A.N. & Ledington J.A. (1988) Traumatic injuries of the temporal bone. Otolaryngol. Clin. North Am. 21, 295–316 3 Yetiser S., Hidir Y., Birkent H. et al. (2008) Traumatic ossicular dislocations: etiology and management. Am. J. Otolaryngol. 29, 31–36
4 Vincent R., Rovers M., Mistry N. et al. (2011) Ossiculoplasty in intact stapes and malleus patients: a comparison of PORPs versus TORPs with malleus relocation and Silastic banding techniques. Otol. Neurotol. 32, 616–625 5 Babu S. & Seidman M.D. (2004) Ossicular reconstruction using bone cement. Otol. Neurotol. 25, 98–101 6 Maassen M.M. & Zenner H.P. (1998) Tympanoplasty type II with ionomeric cement and titanium-gold-angle prostheses. Am. J. Otol. 19, 693–699 7 Ozer E., Bayazit Y.A., Kanlikama M. et al. (2002) Incudostapedial rebridging ossiculoplasty with bone cement. Otol. Neurotol. 23, 643– 646 8 Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. (1995) American academy of otolaryngology-head and neck surgery. Otolaryngol. Head Neck Surg. 113,186–187. 9 Shabana Y.K., Abu-Samra M. & Ghonim M.R. (2009) Stapes surgery for post-traumatic conductive hearing loss: how we do it. Clin. Otolaryngol. 34, 64–66 10 Schwetschenau E.L. & Isaacson G. (1999) Ossiculoplasty in young children with the Applebaum incudostapedial joint prosthesis. Laryngoscope 109, 1621–1625
A purely synthetic and biodegradable material for repair of cerebrospinal fluid rhinorrhoea Surda, P., Syed, I., Modayil, P.C., Little, S.A. & Toma, A. Department of Otolaryngology, St Georges’ Hospital, London, UK Accepted for publication 24 May 2015
Dear Editor, Cerebrospinal fluid rhinorrhoea is defined as the leakage of cerebrospinal fluid through the nasal cavity due to disruption of barriers between the sinonasal cavity and the anterior and middle cranial fossae. The cerebrospinal fluid leaks are often classified as traumatic or non-traumatic.1 The leak can be found directly after the trauma but also many years later. Most leaks are traumatic, and a small number are iatrogenic.1 The main concern with cerebrospinal fluid rhinorrhoea is the high risk of developing meningitis. There is a cumulative risk of meningitis of around 10% per year, and 85% of patients will have had at least one episode of meningitis over a 20-year period,2 hence the need for a watertight closure of these leaks. Cerebrospinal fluid rhinorrhoea repairs are performed by neurosurgeons and otolaryngologists. The approaches for
Correspondence: A. Toma, ENT Department, St George’s Hospital, Blackshaw Road, London SW17 0QT, UK. Tel.: +44 20 8725 3246; Fax: +44 20 87253306; e-mail: [email protected] © 2015 John Wiley & Sons Ltd Clinical Otolaryngology 41, 176–196
surgical closure include intracranial, transnasal and combined. Endonasal endoscopic closure has become the preferred route for repairing cerebrospinal fluid leaks from anterior skull base as it avoids the need for a craniotomy and associated morbidity.3,4 A recent systematic review of endoscopic repair of cerebrospinal fluid leaks has shown a primary closure rate of 90% and low complication rates of
