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  • Title: Management of post-traumatic cerebrospinal fluid (CSF) leak of anterior skull base: 10 years experience.
    Author: Schoentgen C, Henaux PL, Godey B, Jegoux F.
    Journal: Acta Otolaryngol; 2013 Sep; 133(9):944-50. PubMed ID: 23944946.
    Abstract:
    CONCLUSION: Anterior skull base cerebrospinal fluid (CSF) leak should be surgically repaired with an endonasal approach first for less morbidity. Pretherapeutic topographical diagnosis increases the success rate of surgical repair. OBJECTIVES: We aimed to evaluate our efficiency in taking care of post-traumatic anterior skull base CSF leak, since no consensual algorithms for diagnosis and treatment have been established. METHODS: Data from 40 patients treated for post-traumatic CSF leak of the anterior skull base between January 1997 and December 2008 were retrospectively reviewed. Twenty-nine patients were treated with surgery, with an endonasal approach in 14 patients and a neurosurgical approach in 15 patients. A wait and see policy was applied in 11 patients. RESULTS: The overall risk of reccurence was 22.5%. Recurrence was represented by the presence of CSF rhinorrhea in 12.5% and the appearance of meningitis in 10% of patients. The overall risk of postoperative anosmia was 27.5%. A wait and see policy led to a higher risk of developing meningitis than surgical repair (p = 0.0003). The absence of pretherapeutic topographical diagnosis led to a higher risk of recurrence of CSF rhinorrhea (p = 0.01). The endonasal approach resulted in less postoperative anosmia (p = 0.006).
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