PMID: 22338375Feb 18, 2012Paper

Traumatic, iatrogenic, and spontaneous cerebrospinal fluid (CSF) leak: endoscopic repair

B-ENT
J J M DaeleS Machiels

Abstract

Over the past two decades, Cerebrospinal Fluid (CSF) leak repair has advanced from open invasive intracranial approaches to transnasal endoscopic ones that avoid the traditional morbidities of frontal craniotomy approaches--such as anosmia, intracranial haemorrhage or oedema, seizures, memory deficiencies, and behaviour disorders--reducing morbidity, reducing hospitalisation times and accelerating return to work, and therefore cutting indirect costs. The diagnosis of CSF rhinorrhoea is both clinical and radiological. The presence of CSF in clear nasal drainage should be established by analysis for CSF markers. Localisation of the leak site involves radiological investigation, mainly Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI). In addition to suppressing symptoms, the main goal of the closure of CSF rhinorrhoea is to prevent ascending meningitis. The operative management of cerebrospinal fluid leak is advised in the following circumstances: persistent, posttraumatic CSF leaks after 4 to 6 weeks of conservative treatment; all cases of spontaneous CSF fistulae; cases with intermittent leaks; delayed posttraumatic leaks; cases of CSF leak with a history of meningitis; false CSF rhinorrhoea coming from the petr...Continue Reading

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