Endoscopic repair technique for traumatic penetrating injuries of the clivus

Brandon D. Liebelt, Zain Boghani, Ali S. Haider, Masayoshi Takashima

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Unlike basilar skull fractures, penetrating traumatic injuries to the clivus are uncommon. We present two novel and interesting cases of traumatic crossbow arrow injury and penetrating screwdriver injury to the clivus. A review of the literature describing methods to repair these injuries was performed. A careful, systematic approach is required when working up and treating these injuries, as airway preservation is critical. An adaptation to the previously described "gasket-seal" method for skull base repair was utilized to repair the traumatic cerebrospinal fluid (CSF) fistulas. This repair technique is unique in that it is tailored to a much smaller defect than typical post-surgical defects. Two patients are presented, one with a post-traumatic CSF fistula after penetrating crossbow injury to the clivus and one with a penetrating screwdriver injury to the clivus. The patients were treated successfully with transnasal endoscopic repair with fascia lata graft and a nasoseptal flap, a novel adaptation to the previously described "gasket-seal" technique of skull base repair.

Original languageEnglish (US)
Pages (from-to)152-156
Number of pages5
JournalJournal of Clinical Neuroscience
Volume28
DOIs
StatePublished - Jun 1 2016

Keywords

  • CSF fistula
  • Clivus
  • Endoscopic
  • Skull base repair
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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