Extracranial approaches to the repair of cerebrospinal fluid rhinorrhea

D. T. Daly, W. M. Lydiatt, F. P. Ogren, Gary Floyd Moore

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

This paper presents a review of the extracranial evaluation and treatment of cerebrospinal fluid (CSF) rhinorrhea. Diagnosis with attention to a careful history and physical with maneuvers which exacerbate drainage and thorough physical exam along with imaging techniques are discussed. The common etiologies of CSF rhinorrhea including trauma, spontaneous leakage, tumor, and iatrogenic injury are included. Management consists of conservative measures including the avoidance of straining maneuvers which increases intracranial pressure. Periodic drainage of CSF via lumbar puncture or continuous drainage via flow-regulated systems may also be of benefit in attempts of conservative management. Failure of conservative management, constant leakage, pneumocephalus, and recurrent meningitis are indicators for surgical repairs. Ethmoid-cribiform plate region repairs are generally approached by external ethmoidectomy and the development of mucoperiosteal flaps from various donor sites which are then rotated to the leak area to seal the defect. Frontal sinus leaks are usually repaired via an osteoplastic flap technique with direct repair of the dural defect or the use of fascial graft tucked under the bony defect, then obliterated with abdominal fat. CSF rhinorrhea presents a diagnostic and surgical challenge to the otolaryngologist. After diagnosis and localization, operative repair using extracranial approaches is accepted as the initial method of intervention in these cases.

Original languageEnglish (US)
Pages (from-to)311-313
Number of pages3
JournalEar, Nose and Throat Journal
Volume71
Issue number7
StatePublished - Jan 1 1992

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Cerebrospinal Fluid Rhinorrhea
Drainage
Pneumocephalus
Frontal Sinus
Abdominal Fat
Spinal Puncture
Intracranial Hypertension
Wounds and Injuries
Meningitis
History
Tissue Donors
Transplants
Conservative Treatment
Neoplasms
Therapeutics

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Extracranial approaches to the repair of cerebrospinal fluid rhinorrhea. / Daly, D. T.; Lydiatt, W. M.; Ogren, F. P.; Moore, Gary Floyd.

In: Ear, Nose and Throat Journal, Vol. 71, No. 7, 01.01.1992, p. 311-313.

Research output: Contribution to journalReview article

Daly, D. T. ; Lydiatt, W. M. ; Ogren, F. P. ; Moore, Gary Floyd. / Extracranial approaches to the repair of cerebrospinal fluid rhinorrhea. In: Ear, Nose and Throat Journal. 1992 ; Vol. 71, No. 7. pp. 311-313.
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