Skull Base 2007; 17(4): 235-238
DOI: 10.1055/s-2007-981694
ORIGINAL ARTICLE

Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Does Meningitis Stop CSF Rhinorrhea following Lateral Skull Base Surgery?

Tass H. Malik1 , Iain A. Bruce1 , Gerard Kelly2 , Richard T. Ramsden1 , Shakeel R. Saeed1
  • 1University Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Manchester, United Kingdom
  • 2Department of Otolaryngology-Head and Neck Surgery, Leeds General Infirmary, Leeds, United Kingdom
Further Information

Publication History

Publication Date:
01 June 2007 (online)

ABSTRACT

In cases of cerebrospinal fluid (CSF) rhinorrhea following lateral skull base surgery, fibrosis and fibrin formation resulting from meningitis has been postulated as a mechanism of spontaneously resolving the CSF leak. This study was undertaken to explore any possible relationship between the cessation of CSF leak and meningitis. A retrospective study at a tertiary referral center of 232 consecutive patients was performed. Out of a total of 232 procedures, 29 patients developed CSF rhinorrhea, of whom 7 subsequently developed meningitis. Bacteria were isolated in CSF obtained at lumbar puncture in 5 cases, with the CSF analysis in the remaining 2 cases suggesting aseptic meningitis. Conservative treatment failed to stop the CSF rhinorrhea in 6 of 7 cases. In this study, the development of meningitis did not appear to aid in the resolution of the CSF rhinorrhea. We conclude that surgical intervention should not be delayed in the expectation that meningitis and conservative interventions may promote CSF leak resolution.

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Tass MalikF.R.C.S. 

University Department of Otolaryngology-Head and Neck Surgery, Manchester Royal Infirmary

Oxford Road, Manchester M13 9WL, United Kingdom

Email: Tasshm@aol.com