Management of Fallopian Canal Spontaneous CSF Leaks, Implications of Elevated Intracranial Pressure: Case Report and Systematic Review of the Literature. | LitMetric
Objectives: Describe the diagnosis and management of a spontaneous cerebrospinal fluid leak (sCSF-L) through the facial nerve fallopian canal and determine the role of intracranial hypertension (IH).
Study Design: Retrospective case study and systematic review of the literature.
Methods: Reviewed patient characteristics, radiographic findings, and management of the facial nerve canal CSF leak and postoperative IH. Conducted systematic literature review according to the PRISMA guidelines for surgical management and rates of IH.
Results: A 50-year-old female with bilateral tegmen defects and temporal encephaloceles underwent left middle cranial fossa (MCF) repair. Intraoperative CSF egressed from the temporal bone tegmen defects. Facial nerve decompression revealed CSF leak from the labyrinthine segment. A nonocclusive temporalis muscle plug was placed in the fallopian canal, and tegmen repair was completed with bone cement. A ventriculoperitoneal shunt was placed for IH. Postoperative facial nerve function and hearing were normal. A total of 20 studies met inclusion criteria with a total of 25 unique patients. Of 13 total adult cases of fallopian canal CSF leak, there is a 46% recurrence rate, and 86% of patients had documented IH when tested.
Conclusions: Fallopian canal CSF leaks are rare and challenging to manage. Assessment of intracranial hypertension and CSF diversion is recommended along with MCF skull base repair to preserve facial nerve function and conductive hearing.
: Persistent Müllerian duct syndrome (PMDS) is a rare disorder of sex development (DSD) caused by mutations in the genes coding anti-Müllerian hormone (AMH) or the AMH receptor, characterized by the persistence of Müllerian derivatives, the uterus and/or fallopian tubes, in otherwise normally virilized boys. Testicular regression syndrome is common in PMDS, yet the association with supernumerary testis has been reported in only two patients where genetic testing was not performed. : Thus, we report an individual with this particular association caused by a previously unreported homozygous variant in the gene to enable future genotype-phenotype correlations in this rare disorder.
Fallopian tube carcinoma, presenting as an inguinal hernia, is a rare entity. We report the case of a woman in her 70s with a history of hysterectomy and right oophorectomy 29 years prior who presented with left cervical lymphadenopathy and elevated CA125 levels. Imaging revealed a tubular structure in the left pelvic region extending into the inguinal hernia sac.
Different abdominal organs can herniate into the inguinal canal, including the small bowel, colon, appendix, ovaries, and, less commonly, the urinary bladder and fallopian tubes. Herniation of the ureter within an inguinal hernia is a very rare occurrence. To the best of our knowledge, less than 150 cases have been reported in the literature, including only 15 pediatric cases.
Department of Otorhinolaryngology and Head-Neck Surgery, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, Dehradun, Uttarakhand 248016 India.
The risk of iatrogenic facial nerve injury increases in presence of Fallopian canal dehiscence during mastoid surgeries. This study aimed to find out the incidence, site, and size of Fallopian canal dehiscences and their pre-operative & intra-operative predictors. Prospective cross-sectional observational study.
Introduction And Importance: Persistent Mullerian duct syndrome is an exceptional genetic condition that occurs secondary to mutations in AMH and AMHR-II. The individuals with this condition exhibit well-developed secondary sexual characteristics despite having a uterus and fallopian tubes. The case mentioned here was worth reporting due to the scarcity of prevalence of PMDS.
