Surgical management of cerebrospinal fluid rhinorrhoea

A 10-year retrospective review of patients presenting with cerebrospinal fluid (CSF) rhinorrhoea was performed and the success and morbidity resulting from extracranial and craniotomy repair techniques were compared. A classification based upon the aetiology of CSF rhinorrhoea is presented and the radiological techniques used to identify the fistula site are discussed. An emphasis is made upon managing patients on an aetiological basis. This study revealed that extracranial methods of repair had a high success rate with low attendant morbidity. Although craniotomy had comparable success rates this was at the expense of an increase in patient morbidity. Where appropriate, extracranial methods of repair should be the preferred surgical option.