Spontaneous closure of traumatic CSF otorrhoea following conservative management

Lasisi, AK; Kodiya, MA; Udoh, DO

doi:10.4314/ajhs.v13i3.30840

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…4 Following an initial dose of acetazolamide, more than 99% of brain carbonic anhydrase activity is inhibited, thus decreasing CSF production by as much as 48% thereby justifying its utility in CSF rhinorrhea and otorrhea. 5,6 The actual role of acetazolamide in the amelioration of traumatic CSF rhinorrhea and otorrhea is not clear as, till date, very few formal studies have been conducted investigating its impact in the management of CSF fistulae following head trauma. Many clinicians delay its use due to the spontaneous resolution of these leaks.…”

Section: Introductionmentioning

confidence: 99%

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Role of Acetazolamide in Traumatic CSF Rhinorrhea and Otorrhea: A Randomized Controlled Trial

Madeshiya,

Srivastava,

Ojha

et al. 2024

Asian J Neurosurg

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Background Untreated cerebrospinal fluid (CSF) rhinorrhea and otorrhea can lead to adverse complications like meningitis and hence should not be overlooked. Acetazolamide reduces CSF production by 48%. The actual role of acetazolamide in the amelioration of traumatic CSF rhinorrhea and otorrhea is not clear as, till date, very few formal studies have been conducted. Aim of the study was to determine the role of acetazolamide in traumatic cerebrospinal fluid rhinorrhea and otorrhea. Methods A randomized controlled trial was conducted among 134 patients with head injuries presenting to the neurosurgery department of a tertiary care center in North India, with complaints of CSF rhinorrhea and otorrhea within 72 hours of traumatic injury. One-hundred thirty-four patients were randomized into intervention and control group. Comparative analysis was not possible in 58 patients as in due course they were either operated for head injury or lumbar drain was put due to excessive CSF leak; hence, forth comparative analysis was done in 76 patients. Out of these 76 patients, 44 patients belonged to the intervention group (Acetazolamide given) and 32 belong to the control group (Acetazolamide not given). The day of the stoppage of CSF Leak was the main endpoint of this study. Result Majority of the patients were in the age group of 21 to 30 years and were predominantly males. Road traffic accident was observed in 84 (75%) patients. There was no statistically significant difference noted in the mean number of days of CSF leak whether acetazolamide was given or not (p = 0.344). The complication associated with CSF leak was meningitis. The percentage of patients developing meningitis was more after lumber drain insertion. Conclusion In our study, there was no advantage of adding acetazolamide to the conservative management of traumatic CSF leak. Therefore, the practice of routinely giving acetazolamide should be reconsidered.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of Acetazolamide in Traumatic CSF Rhinorrhea and Otorrhea: A Randomized Controlled Trial

Madeshiya,

Srivastava,

Ojha

et al. 2024

Asian J Neurosurg

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“…CSF otorrhoea complicates 6% -30% of basilar skull fractures. 1,2 Cerebral spinal fluid (CSF) leak is a well-known complication of traumatic head injury, and most CSFs occur immediately after the injury or within subsequent days or weeks. It is a physiologic fluid for protecting brain and maintaining intracranial pressure (ICP).…”

Section: Introductionmentioning

confidence: 99%

Post traumatic CSF fistulas – a solved problem?

Satti

Ramooz

Malik

et al. 2021

TPMJ

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Objective: To find the frequency of post-traumatic fistulas in acquire data in neurosurgery department of District Hospital Rawalpindi. Study Design: Descriptive Retrospective Study. Setting: Department of Neurosurgery in District Hospital Rawalpindi. Period: July 2017 to 2019. Material & Methods: Total 70 Patients presented with CSF leaks from either ear or nose or scalp wound following head trauma. All these patients underwent treatment in the emergency room because the study of patients included only those to who presented to emergency with head trauma, including some who underwent some surgical procedure as well, apart from the standard conservative management for all patients. Mean and standard deviation of quantitative data (age), was recorded. Categorical data like gender, early and late onset of disease, surgical treatment were expressed in frequencies & percentage. Results: 70 patients including 52(74.2%) male and 18(25.7%) female. The mean ages was 38.34+13.21 year. CSF leakage was from nose 33(47%) and ear was 37(53%). At the postoperative period, 8(11%) patients had meningitis and 62(89%) patients had no meningitis. Those patients who treated non surgically as 56(80%) as compared to those who underwent some surgical procedures 14(20%). Majority of the patients 59(84%) had early onset < 48 hours of presentation, while 11(16%) had delayed > 48 hours of CSF leakage. Conclusion: CSF fistulas remain a problem after head trauma, with a significant risk of complications and rarely death, hence requiring prompt diagnosis and careful management. Failure of CSF fistula to heal within an average time of 2 weeks of conservative treatment, usually requires surgical treatment.

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“…[2] Its usage is justified by the fact that it reduces CSF production by 48%. [3][4][5][6][7] The actual role of acetazolamide in the amelioration of traumatic CSF rhinorrhea is not clear as, till date, very few formal studies have ben conducted investigating its impact in the management of CSF fistulae following head trauma. The purpose of this study was to investigate whether or not the administration of acetazolamide in head trauma patients with CSF rhinorrhea was beneficial in decreasing the duration of CSF rhinorrhea.…”

Section: Introductionmentioning

confidence: 99%

Is acetazolamide really useful in the management of traumatic cerebrospinal fluid rhinorrhea?

et al. 2015

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Spontaneous closure of traumatic CSF otorrhoea following conservative management

Cited by 3 publications

References 6 publications

Role of Acetazolamide in Traumatic CSF Rhinorrhea and Otorrhea: A Randomized Controlled Trial

Role of Acetazolamide in Traumatic CSF Rhinorrhea and Otorrhea: A Randomized Controlled Trial

Post traumatic CSF fistulas – a solved problem?

Is acetazolamide really useful in the management of traumatic cerebrospinal fluid rhinorrhea?

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