Management of post-traumatic cerebrospinal fluid (CSF) leak of anterior skull base: 10 years experience. (September 2013)

• Record Type: Journal Article
• Authors: Schoentgen, Clement; Henaux, Pierre Louis; Godey, Benoit; Jegoux, Franck
• Is Part Of: Acta oto-laryngologica. Volume 133:Number 9(2013)
• Page Start: 944
• Page End: 950
• Publication Date: 2013-09
• Subjects: Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.3109/00016489.2013.793821
• Languages: English
• ISSNs: 0001-6489

Abstract

<abstract> <title>Abstract</title> <p> <italic>Conclusion:</italic> 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. <italic>Objectives:</italic> 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. <italic>Methods:</italic> 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. <italic>Results:</italic> 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 (<italic>p</italic> = 0.0003). The absence of pretherapeutic topographical diagnosis led to a higher risk of recurrence of CSF rhinorrhea (<italic>p</italic> = 0.01). The endonasal approach resulted in less postoperative anosmia (<italic>p</italic> = 0.006).</p> </abstract>