A 47 year old male presents with intermittent, unilateral nasal drainage and headache. What do you do? In this episode of the BackTable Podcast, Dr. Satyan Sreenath, a rhinologist at Indiana University, and Dr. Sanjeet Rangarajan, a rhinologist at Case Reserve University, examine complex cases involving CSF leaks and encephaloceles.

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SYNPOSIS

The doctors discuss diagnostic approaches, imaging techniques, and innovative surgical methods, using endoscopic and minimally invasive strategies. The conversation highlights the difficulties of diagnosing and surgically repairing these leaks, focusing on their personal experiences and preferred techniques. Through detailed case studies with imaging and surgical videos, they explore the importance of meticulous planning, interdisciplinary collaboration, and adaptive strategies to manage these challenging conditions effectively. A must watch on Youtube!

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TIMESTAMPS

00:00 - Introduction
02:17 - Patient Case 1: “Headache and Drippy Nose..”
02:58 - Diagnostic Imaging and Findings
07:55 - Surgical Approach and Postoperative Care
16:52 - Patient Case 2: “Drippy nose and nasal congestion… just allergies right?”
17:32 - Diagnostic Imaging and Findings
20:21 - Surgical Approach and Postoperative Care
29:03 - Patient Case 3: “Runny nose after my MVC 3 years ago…”
29:21 - Imaging and Surgical Approach Discussion
31:46 - Post-Operative Challenges and Patient Follow-Up
42:46 - Patient Case 4: “Continuous nasal drainage BOTH sides”
43:31 - Imaging and Findings
44:43 - Surgical Approach for Bilateral Defects
56:39 - Final Thoughts

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RESOURCES

Dr. Satyan Sreenath profile:
https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999

Dr. Sanjeet Rangarajan’s profile:
https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-164956839