Success Rate and Complications of Cerebrospinal Fluid Rhinorrhea Treated With a Transcranial Approach

Area of Science:

• Neurosurgery
• Otolaryngology
• Neurology

Background:

• Cerebrospinal fluid (CSF) rhinorrhea is an abnormal leakage of CSF from the cranial cavity into the nasal cavity.
• Causes include spontaneous, traumatic, and iatrogenic factors, with the cribriform plate being a common leakage site.
• Management strategies range from conservative measures to surgical repair, each with varying success rates and complication profiles.

Purpose of the Study:

• To evaluate the clinical outcomes of cerebrospinal fluid (CSF) rhinorrhea patients treated with transcranial surgery.
• To compare the efficacy of transcranial surgery with conservative management for CSF rhinorrhea.
• To identify common leakage sites, etiologies, and associated complications in CSF rhinorrhea.

Main Methods:

• Retrospective review of 23 patients diagnosed with CSF rhinorrhea between 2008 and 2015.
• Analysis of treatment approaches: conservative management versus transcranial surgical repair.
• Data collection included etiology, leakage site, defect size, complications, and surgical repair rates.

Main Results:

• Transcranial surgery was performed in 12 patients (52.2%), while 9 (39.1%) received conservative treatment.
• Spontaneous CSF leaks (30.4%) were unresponsive to conservative measures and often required surgical intervention.
• The primary surgical repair rate was 78.3%, increasing to 91.6% after secondary repairs, with fewer major complications noted.

Conclusions:

• Transcranial surgery is an effective treatment for CSF rhinorrhea, demonstrating higher success rates and fewer complications.
• Spontaneous CSF leaks frequently necessitate surgical intervention, as conservative methods are often insufficient.
• The transcranial approach, particularly preferred in this clinic, shows promising outcomes for managing CSF rhinorrhea.