[Effectiveness of the middle turbinate flap for the treatment of spontaneous fistulas].

Abstract

Background: Currently there is no certainty on which is the best treatment for spontaneous cerebrospinal fluid (CSF) fistulas. This study aimed to test the effectiveness of the pedicled middle turbinate flap (PMTF) in the treatment of said fistulas, located in the anterior skull base floor (ASBF).

Objective: To demonstrate the reduction in recurrence of spontaneous CSF fistulas in the ASBF treated with endoscopic endonasal PMTF.

Material and methods: Ambispective cohort study which included patients with spontaneous CSF fistulas located in the ASBF, treated with PMTF and nasoseptal flap (NSF) by endoscopic endonasal route in a third-level hospital from March 1, 2020, to February 28, 2023. 2 groups were compared: group A, for patients treated with PMTF, and group B, patients treated with NSF. It was calculated chi squared for recurrence, complications and surgical reintervention. A p value < 0.05 was considered significant.

Results: The total was of 13 patients. The most frequent cause was spontaneous (9 cases). PMTF was used in 7 cases and NSF in 6. In group A the recurrence was 42%, and in group B 66% (p = 0.38). Only 1 patient in group A underwent reoperation vs. 4 in group B (p = 0.05).

Conclusions: The use of PMTF has fewer cases of recurrence compared to NSF, even though it was not statistically significant. The statistical significance for reintervention in group A suggests that PMTF may be a viable option for these patients.