Abstract:OBJECTIVE:To analyze the reasons for failure in surgical treatment of cerebrospinal fluid (CSF) rhinorrhea for further renovation in treatment strategies. METHODS:Clinical data of 15 patients with failure or recurrence after surgical treatment of CSF rhinorrhea was analyzed retrospectively. Four of them failed in the first operation and received the second operation, and then relapsed during followup period. The etiology, sites and radiological characteristics of CSF rhinorrhea, and patching materials and reasons for failure were included. RESULTS:Of all the 15 cases,10 cases failed in the first operation.As for the etiology of CSF rhinorrhea, 5 were spontaneous, 3 were traumatic and 2 iatrogenic. Nine cases relapsed after following up morethan 1 month, and their etiological factors were spontaneous (3 cases), traumatic (4 cases) or iatrogenic2 cases). All patients received revisional reconstruction and restoration with fascia lata and none relapsed after followed up for 11 to 39 months postoperatively. CONCLUSION:The sites of traumatic CSF rhinorrhea from frontal sinus often locate at posterior inferior wall, which should be repaired via rhinoorbitalfrontal approach or coronary intracranial approch. Traumatic CSF rhinorrhea might have multiple recessive ventages, and all other latent sites should be carefully examined even when an obvious ventage was found. During operation, the ventage should be enlarged to make fresh wound surface and fascia lata should be used for “sandwich” remedy. The risk factors effecting the outcome of surgery include history of radiotherapy and overweight (high body mass index).
