Surgery for cerebrospinal fluid rhinorrhea and otorrhea.

Abstract

CEREBROSPINAL FLUID leakage into the nasal and ear spaces can be repaired with a resultant lower morbidity and mortality by using extracranial rather than intracranial surgery. Techniques for repair of spinal fluid leakage which cause rhinorrhea, otorrhea, and otorhinorrhea are presented in this paper. The connection of the subarachnoid space with the intranasal space may be via the frontal sinus, sphenoid sinus, cribriform plate, ethmoid sinuses, or from the mastoid and middle ear by way of the eustachian tube. Spinal fluid otorrhea or otorhinorrhea from the middle or posterior fossae by way of the mastoid can be treated by obliteration, using either a local pedicled connective tissue flap or an adipose autograft. If the spinal fluid leakage is subsequent to a radical mastoidectomy, it may be necessary to use a fascia lata graft. A nasal septal mucoperichondrial pedicled flap is used to repair spinal fluid leakage through the cribriform plate,