Cerebrospinal Fluid Leaks Complicating Orbital or Oculoplastic Surgery

Abstract

To report cerebrospinal fluid (CSF) leakage as an unusual complication following orbital or oculoplastic procedures and to describe its diagnosis and management. Retrospective case review. Three cases of CSF leaks are described in patients following orbital or oculoplastic procedures. Two patients developed CSF leaks after orbital decompression surgery for compressive optic neuropathy and 1 patient had a CSF leak following endonasal dacryocystorhinostomy. In the first case, high-resolution computed tomography confirmed the site of the leak that required surgical repair. In the second case, a beta(2)-transferrin test result confirmed the presence of CSF in the nasal drip, and coronal computed tomography identified a small fracture near the fovea ethmoidalis, but the leak resolved within 2 days of bed rest. In the third case, the patient reported several days of nasal dripping, but the problem had already resolved at the first follow-up appointment. A CSF leak following certain orbital and oculoplastic procedures is a rare but well-recognized complication. This case report reviews the mechanisms, diagnostic techniques, and staged management of CSF leaks.