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Acta Otolaryngol. 2013 Sep;133(9):944-50. doi: 10.3109/00016489.2013.793821.

Management of post-traumatic cerebrospinal fluid (CSF) leak of anterior skull base: 10 years experience.

Author information

1
Department of Oto-rhino-laryngology, Head and Neck Surgery, France. cschoentgen@hotmail.fr

Abstract

CONCLUSION:

Anterior skull base cerebrospinal fluid (CSF) leak should be surgically repaired with an endonasal approach first for less morbidity. Pretherapeutic topographical diagnosis increases the success rate of surgical repair.

OBJECTIVES:

We aimed to evaluate our efficiency in taking care of post-traumatic anterior skull base CSF leak, since no consensual algorithms for diagnosis and treatment have been established.

METHODS:

Data from 40 patients treated for post-traumatic CSF leak of the anterior skull base between January 1997 and December 2008 were retrospectively reviewed. Twenty-nine patients were treated with surgery, with an endonasal approach in 14 patients and a neurosurgical approach in 15 patients. A wait and see policy was applied in 11 patients.

RESULTS:

The overall risk of reccurence was 22.5%. Recurrence was represented by the presence of CSF rhinorrhea in 12.5% and the appearance of meningitis in 10% of patients. The overall risk of postoperative anosmia was 27.5%. A wait and see policy led to a higher risk of developing meningitis than surgical repair (p = 0.0003). The absence of pretherapeutic topographical diagnosis led to a higher risk of recurrence of CSF rhinorrhea (p = 0.01). The endonasal approach resulted in less postoperative anosmia (p = 0.006).

PMID:
23944946
DOI:
10.3109/00016489.2013.793821
[Indexed for MEDLINE]

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