Comparative Study between Vascularized Flap and Free Graft in CSF Rhinorrhoea (success rate): Meta-Analysis Study

Abstract

Abstract Background CSF rhinorrhea refers to CSF leakage into the nasal cavity. Most commonly, CSF enters the nasal cavity through defects in the anterior skull base. CSF leak is a serious condition occurring spontaneously or as a result of increased ICP, head trauma, surgery, neoplastic invasion, inflammatory erosion of the skull base, or congenital malformations. Objective Our meta-analysis study is to compare between free grafts and prdicled nasal flaps in repairing CSF rhinorrhea regarding success rate, complications, operative time and hospital stay. Methodology The total number of patients in all the included studies was 524 patients; 339 in the free graft group and 185 in the vascularized flap group. Results Our meta-analysis study showed that success rate in free graft group was 88.5%, while, in vascularized flap group was 93% and the complications rate in free graft group was 39%, while, in vascularized flap group was 39.3%. The result of our meta-analysis showed no significant difference between free grafts and vascularized nasal flaps in reconstruction of skull base in CSF rhinorrhea regarding success rate and complications rate. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Conclusion We found no significant difference between free grafts and vascularized nasal flaps in reconstruction of skull base in CSF rhinorrhea regarding success rate and complications rate. Choosing between them depends on the surgeon’s experience and the location and the size of the defect.