CT-guided open craniocerebral operations for delayed traumatic cerebrospinal fluid rhinorrhea

Abstract

Objective To investigate the value of CT lamellar scan on cranial base and three-dimensional reconstruction towards the diagnosis of traumatic cerebrospinal fluid rhinorrhea (TCFR) and the therapeutic effect of craniocerebral operations on delayed traumatic cerebrospinal fluid rhinorrhea. Methods TCFR in 9 male patients closed with autogroft multistrata repair after open craniotomy between May 2006 and December 2013 were analyzed. Consistency on ventage location determined by preoperative radiological examination and intraoperative probe was compared. Relapse of rhinorrhea and postoperative complications were concluded. Results Basal fracture(or defection), intracranial pneumatocele, and cerebromalacia focus noted on CT scan and three-dimensional reconstruction could accurately indicate the location of ventage. All the 9 patients got a full healing at one stage after rhinorrhea multistrata repair with free or peduncular autologous tissue transplants (e. g. temporal muscle anadesma, abdominal wall fat and temporal muscle flap). There was no relapse during the follow-up of 4-96 months. Except that one patient suffered from epilepsy postoperatively, no other complications occurred. Conclusions Preoperative CT lamellar scan on cranial base and three-dimensional reconstruction provide accurate ventage location of TCFR. Multistrata TCFR repair with autologous tissue transplants may result in a good therapeutic effect with less complications. Key words: Brain injuries; Cerebrospinal fluid rhinorrhea; Craniotomy; Tomography, X-ray computed