Endoscopic Management of Cerebrospinal Fluid Leaks

J. Drew Sanderson; Stilianos E. Kountakis; K. Christopher McMains

doi:10.1055/s-0028-1112229

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2009; 25(1): 029-037
DOI: 10.1055/s-0028-1112229

Endoscopic Management of Cerebrospinal Fluid Leaks

J. Drew Sanderson¹ , Stilianos E. Kountakis² , K. Christopher McMains¹

¹University of Texas Health Science Center at San Antonio, San Antonio, Texas
²Medical College of Georgia, Augusta, Georgia

Abstract

ABSTRACT

Cerebrospinal fluid (CSF) rhinorrhea is an uncommon but important medical condition. It can result from trauma, intracranial hypertension, or be idiopathic in origin. If left untreated, significant sequelae can result including infectious meningitis. Beta-2 transferrin is a sensitive and specific protein marker for CSF. Various radiographic modalities have been used to localize defects, including computed tomography (CT), magnetic resonance imaging, and CT cisternography. In recent years, surgical management of this condition has evolved significantly, primarily being performed endoscopically. Reconstruction can be performed with fat, free mucosal, or fascial grafts, or with vascularized flaps. The endoscopic surgeon should have a thorough understanding of the pathophysiology and diagnosis of CSF rhinorrhea as well as several surgical options in his or her armamentarium available to treat the patient suffering from CSF rhinorrhea.

KEYWORDS

Cerebrospinal fluid (CSF) rhinorrhea - nasal endoscopy and defect repair - cribriform plate - anterior skull base surgery

Full Text

References

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Stilianos E KountakisM.D. Ph.D.

Medical College of Georgia, 1120 15th Street

Augusta, GA 30912

Email: skountakis@mcg.edu