Introduction
Spontaneous cerebrospinal fluid (CSF) leakage occurs because of
increased intracranial pressure; however, it has been reported to be
caused by residual Sternberg’s canal1 and progressive
pneumatization of the lateral fossa of the sphenoid sinus. The increased
intracranial pressure leads to the formation of arachnoid pits, which
leads to progressive bone destruction of the skull
base2-6. Therefore, skull base reconstruction should
be multilayered and as strong as possible.
Despite various techniques reported for multilayer reconstruction of the
skull base, small defects are typically reconstructed using fat or
fascia, while rigid reconstruction has not been
reported7-9.
In this report, we describe a novel technique for managing fistulas of
the lateral wall of the sphenoid sinus through rigid reconstruction in
which a bone pile was formed and inserted similar to the pile-driving
technique. This technique is effective in reconstructing thin and long
fistula-like bone defects, where rigid reconstruction has not been
considered.