The bath-plug closure of anterior skull base cerebrospinal fluid leaks.
BACKGROUND
This study presents the technique and results of cerebrospinal fluid (CSF) leak closure by placement of a fat plug on the intracranial surface of the dura. A prospective cohort study of all consecutive patients undergoing endoscopic closure of an anterior skull base CSF leak using the bath-plug technique was performed at a tertiary care center.


METHODS
Thirty-three patients presented with CSF leaks: 6 were traumatic, 7 were spontaneous, 9 were iatrogenic, and 10 were associated with a meningoencephalocele. The average age of the patients was 40 years and the male-to-female ratio was 1.2:1. All patients underwent the bath-plug technique for closure of CSF leaks. The surgical technique was presented.


RESULTS
Thirty-one of the 33 patients had a successful primary closure of their CSF leak with 2 patients requiring a repeat procedure. After an average of 28 months follow-up, there were no recurrent leaks in any of the patients. This gives a primary closure success rate of 94% and a secondary closure rate of 100%.


CONCLUSIONS
The bath-plug technique for closure of anterior skull base CSF leaks was a reliable technique for a large variety of causes.
Wormald
P J
PJ
Department of Surgery-Otolaryngology, Head, and Neck Surgery, Adelaide University of Australia, Adelaide, Australia.
McDonogh
Mike
M
D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D015331:Cohort Studies; D035262:Cranial Fossa, Anterior / Q000601:surgery*; D004322:Drainage; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009296:Nasal Cavity / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome