Role of Conservative Treatment and Outcome of Traumatic CSF Rhinorrhea

Abstract

Background: Traumatic cerebrospinal fluid (CSF) rhinorrhea, a rare but serious consequence of head injuries, poses significant challenges in diagnosis and management. Understanding the efficacy of treatment modalities is crucial to improve patient outcomes and reduce complications. Objective: This study aims to evaluate the effectiveness of conservative versus surgical treatment in managing traumatic CSF rhinorrhea and to identify factors influencing treatment outcomes. Methods: A descriptive case series was conducted at Jinnah Postgraduate Medical Center, Karachi, from September 2022 to February 2023. Thirty patients with traumatic CSF rhinorrhea, aged 18-60 years, were included. Data on patient demographics, site of CSF leakage, management approach, and recovery were collected. Diagnostic methods involved glucose oxidase test strips and imaging techniques. Statistical analysis was performed using SPSS version 23. Results: Of the patients, 73.3% were male, and 26.7% were female. CSF leakage sites included the sphenoid sinus (36.7%), frontal sinus (33.3%), ethmoidal sinus (20.0%), and cribriform plate (10.0%). Conservative treatment controlled 80% of CSF rhinorrhea cases within 48 hours. Surgical intervention was necessary in 20% of cases, primarily for persistent leaks. The mean age of patients was 40.67±10.54 years. Conclusion: The study indicates that conservative management is effective in the majority of traumatic CSF rhinorrhea cases. However, surgical intervention remains crucial for cases unresponsive to initial treatment. These findings highlight the need for individualized treatment plans and suggest further research into optimizing management strategies for traumatic CSF rhinorrhea.