Background: Spontaneous descent of the CSF (Cerebrospinal fluid) from the\nnose is called rhinorrhea. The causes are defects in bones of the base or meningeal\ntear. The surgical management is still a challenge. The surgical repair\nis a must to prevent the complication which could be brain abscess, meningitis,\nor pneumocephalus. The available surgical management is either transnasal,\nor transcranial. The endonasal route represents an easy access but\nequally aggressive alternative and of limited access. Objective: We reviewed\nthe clinical outcomes of thirteen cases of spontaneous CSF leakage managed\nby transcranial intradural approach. Patients and Methods: This is a retrospective\nstudy about the records of 13 patients who underwent transcranial\nintradural approach as a surgical management for spontaneous CSF rhinorrhea\nin our department in the period between November 2017 and October\n2019. Results: CSF leakage stopped after initial surgery in 12 of 13 patients,\ngiving a success rate of 92.3%. The remaining case did not agree for new surgery\nand the case resolved without surgery for this patient. Postoperative\ncomplications included superficial wound infection in one patient, and\nanosmia in one patient. No other neurological problems were encountered\nover the ten-monthsâ?? follow-up period. Conclusion: The transcranial route is\nthe treatment of choice for patients with anterior cranial fossa spontaneous\nCSF rhinorrhea. A satisfactory surgical outcome depends on exact diagnosis,\nproper operative approach, and the surgeonâ??s skills and experience.
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