Application of a three-dimensional printed model to localize a cranial cerebrospinal fluid leak: a case report

• Published in: Journal of international medical research Vol. 50; no. 2; p. 3000605221078412
• Main Authors: Duan, Hao, Jiang, Xiaobing, Li, Chang, Chen, Mingyuan, Zhang, Bei, Huang, Yuanyuan, Zhao, Qingyu, Mou, Yonggao
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2022; Sage Publications Ltd; SAGE Publishing
• Subjects: Adult; Case Reports; Cerebrospinal fluid; Cerebrospinal Fluid Leak - diagnostic imaging; Cerebrospinal Fluid Leak - etiology; Cerebrospinal Fluid Leak - surgery; Female; Humans; Localization; Magnetic resonance imaging; Meningitis; Neoplasm Recurrence, Local - surgery; Reconstructive Surgical Procedures - methods; Retrospective Studies; Skull Base; Throat cancer; Tomography; cerebrospinal fluid leak; osseous destruction; Three-dimensional printing; case report; bacterial meningitis; nasopharyngeal carcinoma
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/03000605221078412

Localization of defect sites is a major challenge for surgical repair of cerebrospinal fluid (CSF) leaks. Here, we report a case in which we applied a 3-dimensional (3D) printed model to accurately identify the defect sites and facilitate the successful repair of a cranial CSF leak. A 37-year-old female patient diagnosed with recurrent nasopharyngeal carcinoma suffered CSF rhinorrhea and severe bacterial meningitis. Lumbar drainage and antibiotic administration failed to control the condition. In addition to high resolution computed tomography and magnetic resonance imaging, we applied a 3D printed model of the skull to improve the understanding of the osseous destruction at the skull base and aid in accurately localizing the defect sites of the right middle fossa. Accordingly, a right temporalis pedicled flap combined with an autogenous fascia lata flap was applied to cover the defect sites. The leak stopped postoperatively, and meningitis was relieved by enhanced antibacterial treatment. As a complement to high resolution computed tomography and magnetic resonance imaging, a 3D printed model may improve localization of complex defect sites and surgical planning by allowing preoperative visualization of the skull condition.