Visualized Ethmoid Roof Cerebrospinal Fluid Leak during Frontal Balloon Sinuplasty

Sayal, Dr. Navdeep R. DO
Keider, Dr. Eytan DO
Korkigian, Dr. Shant DO

From the Department of Otolaryngology, Beaumont Hospital Farmington Hills, Farmington Hills, Mich.
Department of Otolaryngology, Michigan State University–McLaren Oakland, Pontiac, Mich.

28050 Grand River Ave, Farmington Hills, MI 48336. Email: [email protected]

The case described in this article occurred at Beaumont Hospital.

Ear, Nose & Throat Journal 97(8):p E34-E38, August 2018. | DOI: 10.1177/014556131809700807

Balloon sinus dilation (BSD) is generally accepted as a safe alternative to traditional sinus surgery. It is a unique technique designed to potentially minimize complications associated with traditional functional endoscopic sinus surgery (FESS). We present a case in which a 65-year-old man experienced a cerebrospinal fluid (CSF) leak in the ethmoid roof that was visualized instantly after balloon dilation in a revision sinus surgery. In this case report, we discuss the causes of CSF leaks and explain in detail the immediate endoscopic repair with a collagen matrix. Also, literature is reviewed on the safety of BSD versus traditional FESS. Postoperative-ly, the patient has been without CSF leak and remains symptom free. CSF leak is a rare but major complication during both FESS and BSD. As BSD use increases, its complication profile will become clearer when used alone, in conjunction with FESS, and/or during revision surgery. Although BSD is considered a benign procedure, one should be cautious when using it in revision sinus surgery.