Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
1997-5-22
pubmed:abstractText
Management of patients with cerebrospinal fluid rhinorrhea (CSF) remains controversial. Most studies recommend either an endoscopic or an external extracranial approach, depending on the surgeon's preference. Eighteen patients with CSF rhinorrhea have been managed at our institution since 1990. The causes of the CSF rhinorrhea consisted of functional endoscopic sinus surgery (7), lateral rhinotomy with excision of a benign nasal tumor (3), spontaneous rhinorrhea (7), and secondary repair after intranasal ethmoidectomy (1). In 11 patients the CSF leak was recognized at the time of surgery; in 10 of these patients it was repaired during the primary surgery, whereas one patient underwent secondary repair after failure of conservative management of his CSF fistula. Seven patients underwent exploration for spontaneous CSF rhinorrhea. Four patients had computer tomography scans that showed the leak, and two patients had cisternography to localize the leak. One patient underwent magnetic resonance cisternography. Both of these leaks were identified with cisternography and were then confirmed intraoperatively. Repair methods included a pedicled septal mucosal flap (4), a free mucosal graft from the septum (7), and a middle turbinate (5). Two patients had obliteration of the sinus with muscle/fascia and fibrin glue. Eight patients were repaired endoscopically. The remainder underwent repair through external approaches. Seventeen patients (at a minimum 1 year follow-up) remain free from leakage. One patient required a second repair 8 months after surgery. Iatrogenic trauma remains the most common cause of CSF rhinorrhea. Management at the initial setting is the least morbid approach and is successful in 95% of cases. Whether an endoscopic or external approach is used depends on surgical expertise and experience.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0194-5998
pubmed:author
pubmed:issnType
Print
pubmed:volume
116
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
442-9
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:9141392-Adult, pubmed-meshheading:9141392-Aged, pubmed-meshheading:9141392-Cerebrospinal Fluid Rhinorrhea, pubmed-meshheading:9141392-Endoscopy, pubmed-meshheading:9141392-Ethmoid Bone, pubmed-meshheading:9141392-Fascia, pubmed-meshheading:9141392-Female, pubmed-meshheading:9141392-Fibrin Tissue Adhesive, pubmed-meshheading:9141392-Follow-Up Studies, pubmed-meshheading:9141392-Humans, pubmed-meshheading:9141392-Intraoperative Complications, pubmed-meshheading:9141392-Magnetic Resonance Imaging, pubmed-meshheading:9141392-Male, pubmed-meshheading:9141392-Middle Aged, pubmed-meshheading:9141392-Muscle, Skeletal, pubmed-meshheading:9141392-Myelography, pubmed-meshheading:9141392-Nasal Mucosa, pubmed-meshheading:9141392-Nasal Septum, pubmed-meshheading:9141392-Nose, pubmed-meshheading:9141392-Nose Neoplasms, pubmed-meshheading:9141392-Reoperation, pubmed-meshheading:9141392-Retrospective Studies, pubmed-meshheading:9141392-Surgical Flaps, pubmed-meshheading:9141392-Tissue Adhesives, pubmed-meshheading:9141392-Tomography, X-Ray Computed, pubmed-meshheading:9141392-Turbinates
pubmed:year
1997
pubmed:articleTitle
Contemporary management of cerebrospinal fluid rhinorrhea.
pubmed:affiliation
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown 26506-9200, USA.
pubmed:publicationType
Journal Article