title: Cerebrospinal fluid leak as a complication of oculoplastic surgery.
abstract: OBJECTIVE
  Cerebrospinal fluid leak is a rare, but potentially morbid complication of orbital surgery. In this review, we analyze the reported cases of CSF leak in such surgeries, determine their causes, clinical presentations and sequellae, and highlight the different methods to detect and manage them.
  
  
  METHODS
  A comprehensive literature review was conducted in PubMed.
  
  
  RESULTS
  Twenty-one cases of CSF leak occurred with orbital exenteration, 34 with orbital decompression, four with DCR, two with enucleation, and four cases with other skull base surgery. Operating in high-risk areas increased the risk of dural injury. Once detected, CSF leak was either controlled by bed rest and head elevation or required a surgical repair. The various techniques of surgical management are discussed.
  
  
  CONCLUSIONS
  The number of reported surgical CSF leaks in the orbit is relatively low. To prevent this complication, it is essential to have intimate knowledge of orbital anatomy, especially in the setting of pre-existing abnormalities. If CSF leak occurs, it should be rapidly recognized and adequately managed to prevent further morbidity.
authors.affiliation: Department of Ophthalmology, Harvard Medical School , Boston, Massachusetts , USA and.
authors.forename: Vicky A
authors.initials: VA
authors.lastname: Massoud
authors.forename: Aaron
authors.initials: A
authors.lastname: Fay
authors.forename: Michael K
authors.initials: MK
authors.lastname: Yoon
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D019299:Decompression, Surgical / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D009915:Orbit / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects
keywords: CSF; dacryocystorhinostomy; decompression; exenteration; orbit