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Cerebrospinal fluid leaks following septoplasty
Naren N Venkatesan1, Douglas E Mattox, John M Del Gaudio
1Department of Otolaryngology, University of California Davis Medical Center, 2521 Stockton Blvd., Sacramento, CA 95817, USA. narennv@gmail.com.
Ear, Nose, & Throat Journal
|December 23, 2014
Summary
Cerebrospinal fluid (CSF) leaks after septoplasty are rare but can be serious. These leaks, often on the right side, may be larger and occur years after surgery compared to spontaneous leaks.
Area of Science:
- Otolaryngology
- Neurosurgery
- Medical Complications
Background:
- Cerebrospinal fluid (CSF) leak is a rare complication following septoplasty.
- Previous literature reports few cases of post-septoplasty CSF leaks.
Observation:
- This study reviewed 7 post-septoplasty CSF leak cases and 6 spontaneous CSF leak cases.
- Data collected included leak side, size, and interval between septoplasty and repair.
Findings:
- Post-septoplasty CSF leaks were predominantly on the right side and larger (mean 14.0 × 6.4 mm) than spontaneous leaks (mean 5.8 mm).
- The interval to repair varied significantly: 2.5–20 years for post-septoplasty cases and 3 days–22 weeks for spontaneous leaks.
- Common symptoms included clear rhinorrhea, with some post-septoplasty patients developing meningitis and pneumocephalus.
Implications:
- Right-sided defects post-septoplasty may relate to left-sided surgical approaches.
- Larger defect sizes in post-septoplasty cases suggest a "torque effect" during surgery.
- Understanding these characteristics aids in diagnosing and managing CSF leaks after septoplasty.
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