Extracranial repair of pediatric traumatic cerebrospinal fluid rhinorrhea.
OBJECTIVE
To examine the methods of extracranial repair of traumatic defects in the cribriform plate and ethmoid roof resulting in persistent cerebrospinal fluid (CSF) rhinorrhea in pediatric patients.


METHODS
Retrospective case series.


METHODS
A single-institution, tertiary care, pediatric hospital.


METHODS
Four children, ranging in age from 3 1/2 to 9 years, who sustained fractures in the cribriform plate or ethmoid roof.


METHODS
Transnasal endoscopic repair in 4 patients, with 2 patients also undergoing external ethmoidectomy because of the large bony defect and the need for further exposure for repair.


METHODS
Time free from CSF leaks or recurrence, meningitis, and other postoperative complications.


RESULTS
All patients except 1 have been free of recurrent CSF leaks, meningitis, and other postoperative complications. The 3 patients who solely underwent the extracranial approach did not experience the complications of the traditional intracranial approach.


CONCLUSIONS
In a select group of pediatric patients, the extracranial approach for the repair of CSF leaks is appropriate. Successful use of an extracranial approach in 3 of 4 patients supports this method.
Department of Otolaryngology--Head and Neck Surgery, Children's Hospital of Los Angeles and the University of Southern California School of Medicine, USA. mng@welchlink.welch.jhu.edu
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Ng
D R
DR
Maceri
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MM
Levy
D M
DM
Crockett
D000058:Accidental Falls; D000063:Accidents, Traffic; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies