Minimally Invasive Repair of a Delayed Recurrent Traumatic Cerebrospinal Fluid Rhinorrhea: A Case Report of Dislocation of the Bony and Dural Defects

Abstract

Background：Dural and bony defects mostly occur in the same position in the cerebrospinal fluid（CSF）rhinorrhea of anterior cranial base fractures,and a few cases of delayed CSF leakage after repair are also reported.Case presentation：We report a case in which a pedicled temporoparietal fascial flap was used to repair the comminuted fracture of the anterior skull base with CSF leakage. Delayed CSF leakage occurred 45 days after the operation.A minimally invasive approach through an eyebrow incision was performed for reoperation,it was found that the bony defect was located in the right frontal sinus and the dural defect was located in the right ethmoid plate. Conclusions:This case suggests that delayed traumatic CSF rhinorrhea after reconstructive surgery is more complex than usual,and appropriate approach should be adopted to repair the dural and bony defects , the transeyebrow approach is a good choice.