eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Nasal & Sinus Diseases

CSF Rhinorrhea: Follow-up

Author: Kevin C Welch, MD, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center
Coauthor(s): James Stankiewicz, MD, Professor, Chair, Program Director, Department of Otolaryngology-Head and Neck Surgery, Loyola University Chicago School of Medicine
Contributor Information and Disclosures

Updated: Sep 28, 2009

Outcome and Prognosis

See individual surgical techniques in Surgical therapy.

Future and Controversies

CSF rhinorrhea can occur as a result of craniofacial injury, iatrogenic surgical trauma, or spontaneous causes. Several diagnostic tools are available to aid in diagnosis. In the case of early-onset traumatic fistula, a conservative approach can be used. Other causes require a more aggressive intervention. Endoscopic and external techniques have replaced invasive craniotomy. Because of these techniques, the otolaryngologist plays a key role in diagnosing and managing this problem.

With the growing popularity of computer-assisted, image-guided surgical techniques, the ability to precisely locate areas of CSF leakage is enhanced. This advance may improve the accuracy and precision of closing the defects, with a resulting increase in success rates. In addition, the use of synthetic graft material to repair these defects is another option that has recently become available.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Joseph Scianna, MD, and Srinivas Mukkamala, MD, to the development and writing of this article.



More on CSF Rhinorrhea

Overview: CSF Rhinorrhea
Workup: CSF Rhinorrhea
Treatment: CSF Rhinorrhea
Follow-up: CSF Rhinorrhea
Multimedia: CSF Rhinorrhea
References
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Further Reading

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Keywords

CSF, rhinorrhea, CSF rhinorrhea, cerebrospinal fluid, cerebrospinal fluid rhinorrhea, CSF leak, cerebrospinal fluid leak, traumatic CSF leak, nontraumatic CSF leak, primary nontraumatic CSF leak, secondary nontraumatic CSF leak, secondary nontraumatic CSF rhinorrhea, spontaneous CSF rhinorrhea, paradoxical rhinorrhea, reservoir sign, Queckenstedt-Stookey test, ring sign, double-ring sign, halo sign, CSF rhinorrhea

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Contributor Information and Disclosures

Author

Kevin C Welch, MD, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center
Kevin C Welch, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery and American Rhinologic Society
Disclosure: Nothing to disclose.

Coauthor(s)

James Stankiewicz, MD, Professor, Chair, Program Director, Department of Otolaryngology-Head and Neck Surgery, Loyola University Chicago School of Medicine
James Stankiewicz, MD is a member of the following medical societies: American College of Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Lanny Garth Close, MD, Chair, Professor, Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons
Lanny Garth Close, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physicians, American Laryngological Association, American Society for Head and Neck Surgery, and New York Academy of Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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