title: Spontaneous cerebrospinal fluid leaks in the anterior skull base: a surgical challenge.
abstract: OBJECTIVE
  This retrospective study aimed to evaluate the effective closure rate for spontaneous cerebrospinal fluid leaks with functional endoscopic sinus surgery and identify patient characteristics that may be associated with a need for additional therapy.
  
  
  METHODS
  A retrospective analysis of patients with spontaneous cerebrospinal fluid leaks was performed. Data on the nature of presentation, patient body mass index, defect location and size, intracranial pressure, clinical follow up, and complications were collected.
  
  
  RESULTS
  Twenty-five patients had spontaneous cerebrospinal fluid leaks with evidence of idiopathic intracranial hypertension. The most common sites were the cribriform plate, followed by the ethmoid roof and sphenoid lateral pterygoid recess. All patients underwent endonasal endoscopic surgery to repair the defect. Post-operatively, all patients underwent lumbar drainage and acetazolamide therapy.
  
  
  CONCLUSIONS
  Spontaneous cerebrospinal fluid leaks represent a surgical challenge because of their high recurrence rates. The most important factor for obtaining a successful repair in these patients is reducing their intracranial pressure through nutritional, medical or surgical means.
authors.affiliation: Service of ENT-Head and Neck Surgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: G
authors.initials: G
authors.lastname: Martínez-Capoccioni
authors.affiliation: Service of Neurosurgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: R
authors.initials: R
authors.lastname: Serramito-García
authors.affiliation: Service of ENT-Head and Neck Surgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: B
authors.initials: B
authors.lastname: Huertas-Pardo
authors.affiliation: Service of Neurosurgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-Allut
authors.affiliation: Service of ENT-Head and Neck Surgery,Servizo Galego de Saúde,University Hospital Complex of Santiago de Compostela,Santiago de Compostela,Spain.
authors.forename: C
authors.initials: C
authors.lastname: Martín-Martín
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000209:etiology / Q000601:surgery*; D035262:Cranial Fossa, Anterior / Q000601:surgery; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000628:therapy*; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D009666:Nose / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies
keywords: Endoscopic Surgical Procedures