Repair of Cerebrospinal Fluid Leaks

Alan P. Johnson

This chapter focuses solely on surgical management of cerebrospinal fluid (CSF) rhinorrhea. The impetus behind surgical repair of CSF leaks is prevention of meningitis. The risk of meningitis in CSF rhinorrhea is of the order of 1% per week while the leak is occurring. Surgery is indicated if conservative measures fail to control the leak.

• The analysis of liquid for the presence of tau protein or transferrin is highly specific and sensitive for CSF and is now the diagnostic test of choice.
  
• Glucose is present in CSF but not nasal mucus, but analysis for glucose is significantly less sensitive and specific and should not be used to confirm or refute the diagnosis.