Endoscopic management of cerebrospinal fluid leaks.
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.
Sanderson
J Drew
JD
University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Kountakis
Stilianos E
SE
McMains
K Christopher
KC
D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D009192:Myelography; D044583:Neuroendoscopy / Q000379:methods*; D011182:Postoperative Care; D019651:Plastic Surgery Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014168:Transferrin / Q000134:cerebrospinal fluid
D014168:Transferrin