Diagnosis and treatment of traumatic delayed cerebrospinal fluid rhinorrhea / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the etiological factor, diagnostic localization and treatment of delayed cerebrospinal fluid (CSF) rhinorrhea.</p><p><b>METHODS</b>The medical records of 79 patients who had undergone endoscopic repair of CSF rhinorrhea between 2000 and 2008 were reviewed. Thirteen patients with CSF leaks occurred 3 months after head trauma. All 13 patients with delayed CSF leak were retrospectively evaluated with CT or MRI and surgically treated. The operative findings were compared with the results of CT or MRI to estimate the diagnostic value of imaging technique.</p><p><b>RESULTS</b>Bony defects had been found on CT scanning in all 13 patients. Neural tissue herniation into the nasal sinuses was found in 11 patients during the surgery. The sizes of the leak ranged from 0.1 cm x 0.2 cm to 1.2 cm x 1.5 cm. Reconstruction of the skull base was done through endoscopic approach. No complications were found. Thirteen patients were followed up from 12 - 36 months, and none was recurrence.</p><p><b>CONCLUSIONS</b>Herniation of mucosal tissue into the nasal sinuses after skull base defects could result in delayed CSF leak. CT and MRI can clearly show the skull base defects and neural tissue herniation. Endoscopic closure of CSF leaks was both safe and effective.</p>