Once the province of neurosurgeons, cerebrospinal fluid (CSF) leak repair is now handled mostly by otolaryngologists. This change has occurred over the past couple of decades, during which time the evolution of endoscopic tools and techniques has made possible extracranial rather than intracranial repair. The success rate for repairing these leaks from below has reached about 90 percent, particularly for small leaks (Laryngoscope. 1996;106:1119-1125).
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But despite the high success rate for the repair of leaks from small skull base defects, several challenges remain, otolaryngologists say. Among these are leaks that result from larger defects caused by endoscopic intracranial work.
Laryngoscope. 2004;114:255-265. Copyright 2004 the American Laryngological. Rhinological and Otological Society, Inc.
“Otolaryngologists must understand the difference between routine cerebrospinal fluid leak repairs of small defects such as those seen after trauma, as opposed to large defects seen with endoscopic skull base resections that require extended, multi-layer reconstruction,” said Rodney J. Schlosser, MD, professor and director of rhinology and sinus surgery at the Nose and Sinus Center, Medical University of South Carolina in Charleston.