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Endoscopic cerebrospinal fluid rhinorrhea repair: is a lumbar drain necessary?
1University of Miami School of Medicine, Florida, USA.
Objectives:
To determine the necessity for lumbar drains during endoscopic cerebrospinal fluid (CSF) rhinorrhea repair.
Methods:
Thirty-three patients underwent endoscopic repair of CSF rhinorrhea without a lumbar drain during a 7-year period. The size of the dural defect ranged from a microleak (less than 1 mm dural defect) to a 3-cm dural defect of the anterior skull base.
Results:
All of the procedures in patients with smaller defects (<5 mm) were performed on an outpatient basis. Thirty-two patients (97%) had complete resolution of their CSF leak after 1 procedure without any recurrence (average follow-up 29 months).
Conclusion:
A lumbar drain is not routinely necessary for successful closure of CSF rhinorrhea of any size. Smaller dural defects may be safely performed on an outpatient basis without complications.