Title:
Traumatic CSF leaks of the anterior skull base
Authors:
T. Van Zele and F. Dewaele
Institutions:
Department of Otorhinolaryngology, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium; Department of Neurosurgery, Ghent University Hospital, Belgium, De Pintelaan 185, 9000 Gent, Belgium
Keywords:
Skull base; trauma; cerebrospinal fluid leak; cerebrospinal fluid leakage; cerebrospinal fluid rhinorrhoea; post-traumatic
Pages:
19 - 27
Abstract:
Traumatic CSF leaks of the anterior skull base. Skull base fractures are a frequent complication of high-impact trauma; due to the inherent anatomic relationships of the skull base, they may be associated with significant intracranial complications, including CSF leakage, and their detection is therefore important. The ethmoid roof and the cribriform plate region are the sites most vulnerable to fractures and dural tears. Rhinorrhoea is a non-specific finding; the presence of CSF in a sample must be confirmed with beta 2 transferin or beta trace protein. Accurate identification of the leakage site is necessary for a successful surgical treatment. Various modalities are available for this purpose, such as CT scan and MRI. Persistent CSF rhinorrhoea necessitates surgical intervention, due to the risk of meningitis. Continued improvements in endoscopic reconstruction techniques have led to fewer open surgeries for repair. Smaller defects can be closed with fat, gasket technique or free grafts, while larger defects necessitate a multilayer closure with local vascularized flaps. These techniques have shown consistently high success rates.
Issue:
Suppl. 26.2, 2016


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Traumatic CSF leaks of the anterior skull base