title: A 7-year study of 1,278 patients with maxillofacial trauma and cerebrospinal fluid leak.
abstract: BACKGROUND
  A number of patients with facial fractures have cerebrospinal fluid (CSF) leak that may result in meningitis and other central nervous system complications. Commonly, CSF leak occurs following trauma, but the etiology and pattern of this disorder are different from region to region. This study aims to evaluate the distribution of CSF leak in patients with maxillofacial fractures in Isfahan province, Iran.
  
  
  METHODS
  In this retrospective cross-sectional study, 1,287 medical files of patients admitted to a medical center with head and face injuries were evaluated during a 7-year period (2004-2010). Data was obtained using descriptive analysis.
  
  
  RESULTS
  Of the 1,278 patients with head and maxillofacial fractures, 16 (1.25 %) males and one (0.07 %) female had CSF leak; all these cases had skull base fracture. Of these, 52.9 % had maxillary fracture, 23.5 % nasal fracture, 41.1 % orbital fracture, 11.7 % mandibular fracture, 23.5 % frontal fracture, and 41.1 % had more than one site of fracture. 58.8 % had rhinorrhea and 41.2 % otorrhea. Of all these patients with CSF leak, 8 (47 %), 2 (11.8 %), and 7 (41.2 %) cases were treated spontaneously, using lumbar drain placement, and by surgical intervention, respectively.
  
  
  CONCLUSIONS
  Cerebrospinal fluid leak was observed most frequently in patients with fracture in the zygomatic and maxillary bone, and mostly exhibited itself as rhinorrhea and/or otorrhea. All cases with CSF leak had skull base fracture as well. However, post-traumatic CSF leaks are uncommon and are generally treated without surgical intervention (59 %). Distribution of CSF leak varies from one region to another and knowing this fact helps to manage the injury and prevent the complications.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Hezar-Jarib Ave., Isfahan, Iran.
authors.forename: Dariush
authors.initials: D
authors.lastname: Hasheminia
authors.affiliation: Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mahmood Reza
authors.initials: MR
authors.lastname: Kalantar Motamedi
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Hashemzehi
authors.affiliation: Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Rahman
authors.initials: R
authors.lastname: Nazeri
authors.affiliation: Department of Oral and Maxillofacial Surgery, Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Hezar-Jarib Ave., Isfahan, Iran.
authors.forename: Bijan
authors.initials: B
authors.lastname: Movahedian
keywords: Cerebrospinal fluid leakage; Cerebrospinal fluid otorrhea; Cerebrospinal fluid rhinorrhea; Cranial base; Facial bones