Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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The patient was operated for
Ewing sarcoma 05-September-2009 and was ready
for discharge 08-September-2009, before what she
progressed CSF leak. Mannitol was started and
three dressings done and the CSF continued
The wound was opened and the
CSF leak was coming from the axilla of the right
C3 root , where meticulous cleaning of the tumor
was performed during the first operation.
Nylon 6 zero was used to
stitch the healthy dura in water-tight fashion
and surgicel was applied superior, inferior and
over the axilla.
The patient was put in
several positions and Valsalva maneuver
was applied to seek for other CSF leak points.
It was negative. A piece of muscle was crushed
and covered over the repaired area for further
assurance and Gentamicine washing of the wound
Routine closure of the
wound and smooth
and the patient sent to
Surgical intervention in this
case was mandatory, not only to prevent CSF
leak, but also to prevent seed of the tumor
intradurally. It could possibly invaded it
as the left C3 root was tumorous, but the defect
could accelerated the CSF seed of the tumor
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .