Management of unexpected cerebrospinal fluid leak during endoscopic sinus surgery.
OBJECTIVE
Cerebrospinal fluid leak during endoscopic sinus surgery is a potentially devastating complication; however, identification and appropriate management can prevent unfavorable outcomes. The purpose of this review is to outline the recent advances in the management of cerebrospinal fluid leaks that occur during endoscopic sinus surgery.


RESULTS
The low incidence of this complication makes prospective and randomized study difficult. The expanding role for endoscopic skull base surgery has brought new techniques and advances in the treatment of skull base reconstruction and cerebrospinal fluid fistula repair that can be applied to intraoperative leaks that occur during sinus surgery. Recent reports have focused on the prevention, identification, repair materials, repair technique, and infectious sequelae related to this complication.


CONCLUSIONS
Several successful techniques that utilize a variety of materials are available for the repair of cerebrospinal fluid leaks encountered during sinus surgery. The clinical scenario will determine the appropriate use of repair material, technique, and postoperative care.
Platt
Michael P
MP
Department of Otolaryngology, Head and Neck Surgery, Boston University, Boston, Massachusetts, USA. Michael.Platt@BMC.org
Parnes
Steven M
SM
D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D010256:Paranasal Sinuses / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D018570:Risk Assessment; D019291:Skull Base / Q000601:surgery; D016896:Treatment Outcome