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.