In November 1998, Jeffrey sought the medical expertise of Frank J Scaccia MD, a Riverview Medical Center ear, nose and throat specialist with a practice in Red Bank. After performing a nasal endoscopic exam, Dr Scaccia began to suspect that Jeffrey’s problem was more than an allergy or upper respiratory infection. In fact, he thought it may be a much more serious medical condition a cerebral fluid (CFS) leak.

A CT scan of Jeffrey’s sinuses and brain verified Dr Scaccia’s suspicions and further indicated that a large mass was either eroding into the sinuses from the brain or from the sinuses into the brain.

This was a very unusual presentation for a CFs leak since there was no proceeding event of trauma or surgery that would cause this, says Dr Scaccia. ‘‘Jeffrey was extremely lucky not to have developed neurological complications such as meningitis or a brain abscess considering the length of time this had been occurring.”

Riverview neurosurgeon Bruce Rosenblum MD, examined Jeffrey and his test results. Both physicians agreed that immediate surgery was necessary. Four days before Thanksgiving, Jeffrey was admitted to Riverview Medical Center for surgery.

High-Tech Surgery Close to Home
‘‘It was important for me to be at Riverview because it was close to home and my then 10-year-old daughter could visit everyday which she did,” explains Jeffrey. ‘‘Although I was confident in my physicians, we really didn’t know how the surgery would turn out and I wanted to be able to see her as often as possible. That was important to both of us.”

During the first part of the surgical procedure, called a bifrontal craniotomy, the herniated brain tissue was identified . This condition occurs when the brain tissues pushes into the sinuses and nose. Dr Rosenblum, with assistance of Dr Scaccia, separated a portion of the tissue that had decompressed into the sinus/nasal passages and restored the affected area with a section of the Jeffery’s own leg muscle. The second part of the surgery required Dr Scaccia to perform a septoplasty and endoscopic sinus surgery to remove the separated brain tissue from the nasal/sinus cavity.

One day after surgery Jeffrey was up and walking. Within just a few days he left Riverview Medical Center with out complications and or neurological
consequences. Jeffrey says he feels like a new man. He has had no recurrence of the condition his breathing is better, his headaches are gone and he is back at work.