Traumatic cerebrospinal fluid fistulas in the anterior and middle cranial fossae

Abstract

SummaryA survey of 164 cases of traumatic CSF rhinorrhoea, and 33 cases of CSF otorrhoea is presented. The problems of diagnosis, operative treatment, and frequency of recurrence, are considered. Anterior fossa injuries can still present problems, even though the diagnosis has been greatly facilitated by the introduction of computer tomography.

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

“…For fractures involving the frontal sinus, for example, obliteration is accomplished first by meticulous stripping of sinus mucosa, removing the posterior table of the sinus, and then packing the communication between the frontal sinus and the nasal cavity with autogenous fat or muscle. 46,66 The risk of a recurrent leak after transcranial repair of traumatic CSF rhinorrhea has been reported to be 6%-32%. 10,43,46,66,68,69,99,104,118 Extracranial repairs can be achieved through different types of approaches.…”

“…46,66 The risk of a recurrent leak after transcranial repair of traumatic CSF rhinorrhea has been reported to be 6%-32%. 10,43,46,66,68,69,99,104,118 Extracranial repairs can be achieved through different types of approaches. The most frequently used has been the transnasal approach, first described by Hirsch 54 in 1952.…”

Diagnosis and treatment of frontobasal skull fractures

“…While the concept of operating on otobasal fractures only in cases of persisting liquorrhea is generally accepted [2], the indication for surgical treatment of frontobasal skull fractures is still discussed controversially [21,22,24]. Even when rhinoliquorrhea in the immediate posttraumatic phase is evident, some neurosurgeons are reluctant to operate, while others advocate surgery as early as possible whenever dura laceration is suspected [15,16,21]. During the last five years, we have used high-resolution CT for the diagnosis of all frontobasal skull fractures.…”

CT cisternography role in posttraumatic basal liquorrhea diagnostics

“…ПБЛ возникает при повреждении основания передней (ПЧЯ) или средней (СЧЯ) черепной ямки с вовлечением в процесс околоносовых пазух (ОНП) [4]. При переломе каменистой части пирамиды ви-сочной кости и сосцевидного отростка в области ячеек возникает ушная ликворея [5].…”

“…Из инструментальных методов широко применяют эндоскопию полости носа с эндолюмбальным введе-нием натрия флуоресцината или без такового [13]. В диагностике ПБЛ применяют краниографию [4], спиральную компьютерную томографию (СКТ) с 3D-реконструкцией или без таковой [14], рентгено-логическую фистулоцистернографию [15], КТ-цистер-нографию [16], МРТ-цистернографию [17].…”