Treatment of cerebrospinal fluid rhinorrhea

Adam S. Deconde, Jeffrey D. Suh, Vijay R. Ramakrishnan

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

PURPOSE OF REVIEW: Cerebrospinal fluid (CSF) rhinorrhea is a rare entity that can arise from a variety of causes. Successful management has been reported using a variety of repair techniques. The goal of this study is to make recommendations on intraoperative and postoperative management of CSF fistulas across all causes. RECENT FINDINGS: Pooled analysis of case series reveals that free graft repairs are successful in closing most traumatic and iatrogenic CSF leaks. In contrast, multilayered, vascularized repairs are often required for large defects with high-flow leaks that communicate with a cistern and/or ventricles. Spontaneous CSF leaks are associated with idiopathic intracranial hypertension in the vast majority of cases, and when present, postoperative medical management is necessary for long-term success. SUMMARY: Patients with CSF rhinorrhea require surgical repair to prevent life-threatening complications. Many techniques and materials are effective at achieving closure of CSF fistula across causes. Evidence suggests that patients with high-flow CSF fistulas have improved outcomes with multilayered, vascularized repairs to decrease the risk of postoperative CSF leaks. Patients with idiopathic intracranial hypertension need long-term management of the underlying disease process.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Volume23
Issue number1
DOIs
StatePublished - Feb 21 2015

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Keywords

  • cerebrospinal fluid fistula
  • cerebrospinal fluid rhinorrhea
  • skull base defect
  • skull base repair
  • spontaneous cerebrospinal fluid leak

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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