title: Effect of lumbar drain placement on recurrence of cerebrospinal rhinorrhea after endoscopic repair.
abstract: BACKGROUND
  Lumbar drain (LD) use in the management of cerebrospinal fluid (CSF) rhinorrhea remains controversial. We analyzed the relationship between LD placement and CSF leak recurrence after endoscopic repair.
  
  
  METHODS
  A retrospective case series was conducted. Patients who underwent CSF leak repair from 1999 to 2010 were identified. Data collected included demographics, body mass index (BMI), history of obstructive sleep apnea (OSA) or idiopathic intracranial hypertension (IIH), associated meningoencephalocele, etiology and site of leak, LD placement, fluorescein and antibiotic use, recurrence, and site of recurrence. Correlation between LD placement and leak recurrence was analyzed.
  
  
  RESULTS
  A total of 105 patients underwent CSF leak repair. A total of 68 patients had an LD. Of these 68 patients, 15 (22%) had a recurrent leak. Of the 105 patients, 37 did not have an LD, and 5 of the 37 (14%) recurred. Recurrence rates with and without LD were not significantly different (p = 0.15). Of the 105 patients, 40 (38%) had a spontaneous leak, 15 (14%) had a traumatic leak, and 50 (48%) had an iatrogenic leak. In the spontaneous group, 30 of 40 patients had an LD and 10 of 40 did not. Recurrence was not significant between these subgroups (p = 1.0). LD was used in 11 of 15 patients with traumatic leaks. Of these 15 patients, 4 did not have a drain. Recurrence was not significant between these subgroups (p = 1.0). In 27 of 50 patients with an iatrogenic leak, an LD was placed. Of 50 patients, 23 did not have an LD. There was no statistical significance when the recurrence rates for these subgroups were compared (p = 0.26).
  
  
  CONCLUSIONS
  In our study, there was no association identified between LD placement and recurrence rates after endoscopic repair of CSF rhinorrhea.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Neurosciences, Stritch School of Medicine, Loyola University Hospital, Maywood, IL 60153, USA.
authors.forename: Nadieska
authors.initials: N
authors.lastname: Caballero
authors.forename: Vidur
authors.initials: V
authors.lastname: Bhalla
authors.forename: James A
authors.initials: JA
authors.lastname: Stankiewicz
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Welch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery*; D002648:Child; D004322:Drainage / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents