Cerebrospinal fluid rhinorrhoea and otorrhoea: extracranial repair

Cerebrospinal fluid otorhinorrhoea is a well recognized problem. The otolaryngologist has a major role to play in the diagnosis and management of this condition. Five cases are described which illustrate the problems involved; four presented as leaks and one as pneumoencephalus and meningitis. Of the various methods of diagnosis and localization non-invasive techniques, i.e. tomography, CT and flexible endscopy are preferred. The extracranial extradural approach for anterior, middle and posterior fossa leaks allows a direct assault on the fistula. It may be usefully augmented by temporary lumbar drainage.