• Ramón Moreno-Luna, Eugenio Cárdenas Ruiz-Valdepeñas, José Ignacio Tato, Monica Rivero-Garvia, Javier Márquez-Rivas, and Antonio Mochón Martín.
• Rhinology Unit, Department of Otolaryngology, University Hospital Virgen Macarena, Sevilla, Spain. Electronic address: ramoluorl@gmail.com.
• World Neurosurg. 2016 Sep 1; 93: 484.e9-484.e12.

BackgroundAdenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). In turn, cerebrospinal fluid fistula is a very uncommon but critical complication in this type of surgery.MethodsWe report the case of a 3-year-old patient who underwent adenoidectomy and presented a cerebrospinal fluid leak associated with pneumocephalus and meningitis.ResultsThe solution provided was a suture in layers of the fistula tract, reinforced with basipharyngeal vascularized and rotation random flap of mucosa, and a free graft of muscle, through a transoral endoscopic approach.ConclusionsCerebrospinal fluid leak as a complication after adenoidectomy is exceedingly rare. These pharyngospinal fistulae are determined by the anatomic features associated with intraoperative hemorrhagic complications, and it is essential that we take them into account when facing postoperative complications in the follow-up. The use of vascularized flaps based on the irrigation of the ascending pharyngeal artery with endoscopic techniques offers low-morbidity solutions, which are more efficient than traditional methods.Copyright © 2016 Elsevier Inc. All rights reserved.

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