PT - JOURNAL ARTICLE AU - Tiffany Mathias AU - Joshua Levy AU - Adil Fatakia AU - Edward D. McCoul TI - Contemporary Approach to the Diagnosis and Management of Cerebrospinal Fluid Rhinorrhea DP - 2016 Jun 20 TA - Ochsner Journal PG - 136--142 VI - 16 IP - 2 4099 - http://www.ochsnerjournal.org/content/16/2/136.short 4100 - http://www.ochsnerjournal.org/content/16/2/136.full SO - Ochsner J2016 Jun 20; 16 AB - Background: Cerebrospinal fluid (CSF) rhinorrhea, when left untreated, can lead to meningitis and other serious complications. Treatment traditionally has entailed an open craniotomy, although the paradigm has now evolved to encompass endoscopic procedures. Trauma, both accidental and iatrogenic, causes the majority of leaks, and trauma involving skull base and facial fractures is most likely to cause CSF rhinorrhea. Diagnosis is aided by biochemical assay and imaging studies.Methods: We reviewed the literature and summarized current practice regarding the diagnosis and management of CSF rhinorrhea.Results: Management of CSF leaks is dictated by the nature of the fistula, its location, and flow volume. Control of elevated intracranial pressure may require medical therapy or shunt procedures. Surgical reconstruction utilizes a graduated approach involving vascularized, nonvascularized, and adjunctive techniques to achieve closure of the CSF leak. Endoscopic techniques have an important role in select cases.Conclusion: An active surgical approach to closing CSF leaks may provide better long-term outcomes in some patients compared to more conservative management.