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Indian Journal of Neurosurgery 2012; 01(01): 023-027
DOI: 10.4103/2277-9167.94366
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Surgically repaired posttraumatic CSF rhinorrhea: An institutional experience and review of literature

Brijesh Kumar
,
Rajkumar,
Rabinarayan Sahu
,
A.K. Srivastava
,
Anup P. Nair
,
Anant Mehrotra
Subject Editor:
Further Information

Publication History

Publication Date:
18 January 2017 (online)

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Abstract

Introduction

Posttraumatic cerebrospinal fluid (CSF) rhinorrhea frequently complicates anterior skull base fracture. Although skull base fracture is present in only about 7% cases of head injury, CSF rhinorrhea develops in 30% of cases with basal fracture.

Materials and Methods

A total of 43 cases admitted in our Institute (SGPGI Lucknow) from January 2000 to June 2011with history of head trauma followed by CSF rhinorrhea. Forty one cases were included in this study as two patients refused surgery.

Result

Out of forty one cases, 26 cases (63%) were admitted with history of recurrent meningitis, 21 cases (51%) with loss of smell, 26 cases (63%) with delayed onset CSF rhinorrhea, 3 cases (7%) with early onset rhinorrhea which did not improve after trauma, 12 cases (30%) with early onset rhinorrhea which improved but reappeared after some time. Twenty cases (48.8%) were repaired by extradural approach, 10 cases (24.4%) were repaired by intradural approach and 11 cases (26.8%) were repaired by endoscopic approach. 12 cases (29.0%) required re-surgery for persistent or recurrence of CSF rhinorrhea.

Conclusion

Although posttraumatic CSF rhinorrhea usually resolves with conservative management, its persistence makes an individual prone for further complications like meningitis, brain abscess and septicaemia. Timely surgical intervention usually gives promising results. Endoscopic repair was better than transcranial repair.

Key words

Endoscopic repair - posttraumatic CSF rhinorrhea - transcranial repair
 

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