The meninges contain a fluid known as cerebrospinal fluid (CSF), which continuously circulates the surface of the brain and spinal cord as well as through the ventricles of the brain. This CSF movement ensures that nutrients are distributed to all areas of the brain and spinal cord, helps remove contaminants from the brain and acts as a protective covering for the brain and spinal cord.
CSF leaks can cause fluid to leak through the ears, nose, or spinal canal, causing unbearable pain. Such a leakage must be immediately taken care of and treated to curb any possibility of developing meningitis, an infection of the meninges.
CSF Leak Treatment
A CSF leak is a very critical condition and must not be overlooked. To avoid developing meningitis and chronic headaches, patients, experiencing tears in their dura with persistent CSF leaks must, without fail, consult an ENT doctor and treat the affected area.
Nasal CSF Leak
In case of a CSF leak through the nostrils, surgery for endoscopic nasal CSF leak closure is conducted, which eliminates the need to make any cuts on the skin because it is repaired by using tissue from the nose or with a biomaterial graft. Generally, a patient is monitored post-surgery in the hospital and let to return home in a few days, but patients requiring a lumbar drain may be asked to wait longer.
Ear CSF Leak
Ear CSF leak closure requires making a tiny incision at the mastoids, bony tissue, to access the source of the leak. The leak is then repaired using one's tissue, and the cut is sealed using surgical threads.
Spinal CSF Leak
For CSF leaks into the spinal canal, the physician uses CT guidance to inject a small amount of the patient's blood or the fibrin patches, i.e. protein in blood that helps it clot into the spinal canal to see if it heals through self-recovery. This method is often successful, but if consecutive attempts fail, the doctor may conduct a duraplasty.
Anterior skull base tumours
In addition to endoscopic and open skull base surgery, these endoscopic treatment in Hebbal, Bangalore may be needed, depending on the type of growth or abnormality of the skull base,
Chemotherapy. These are drugs used to treat changes caused by cancer.
Radiation therapy. X-ray treatment may be used to control growth in the skull base that can't be entirely removed by surgery.
Gamma knife. This type of radiation therapy uses precise X-ray beams to target growth in the skull base.
Proton beam therapy. This is another type of radiation therapy designed to have greater accuracy and dosing for tumours.
Particle therapy. This is the newest form of radiotherapy, and it uses high-energy particles with fewer side effects. Carbon-ion radiotherapy is a form of particle therapy.
Skull base surgery can be done in two main ways. Although the preferred method is endoscopic, open surgery is also an option, depending on the type of growth that needs to be removed and its location:
Endoscopic or minimally-invasive skull base surgery. This type of surgery usually does not require a large incision. A surgeon may make a small opening inside the nose to allow a neurosurgeon to remove a growth through a thin, lighted tube called an endoscope. An MRI is a picture of the skull base using magnets and a computer. A radiology specialist may do it while the surgical specialists are operating to help them make sure all of the growth has been removed.
Traditional or open skull base surgery. This surgery may require incisions in the facial area and the skull, and parts of the bone may need to be removed so that the growth can be reached and removed. An operating room microscope is often used for this type of surgery.
After skull base surgery, you will be closely cared for by your medical team. Their goal is to allow you to return to normal activities of daily living. Some people need continued therapy, including radiotherapy, radiosurgery, and proton beam therapy. Many will need repeated imaging to ensure that growth does not come back over time. Because this type of surgery can be very stressful, getting support from friends and family is essential. Your treatment team can also provide mental health and support group resources for you and your family.
Consult with best ENT doctors in Hebbal at Manipal Hospitals to know more about treatments.