Search Our Scientific Publications & Authors

J Neurol Surg B Skull Base 2018 Aug 10;79(4):330-334. Epub 2017 Nov 10.

Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States.

 Primary closure of posterior fossa dura can be challenging, and postoperative cerebrospinal fluid (CSF) leaks continue to represent a common complication of the retrosigmoid approach. We describe a simple technique to allow for primary closure of the dura following retrosigmoid approaches. The incidence of CSF leaks using this method is reported. Read More

Diagn Interv Imaging 2018 Jun 14. Epub 2018 Jun 14.

Department of Radiodiagnosis, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, 689101 Kerala, India.

Cerebrospinal fluid (CSF) leaks are extracranial egress of CSF into the adjacent paranasal sinus or tympanomastoid cavity due to an osteodural defect involving skull base. It can be due to a multitude of causes including accidental or iatrogenic trauma, congenital malformations and spontaneous leaks. Accurate localization of the site of the leak, underlying causes and appropriate therapy is necessary to avoid associated complications. Read More

World Neurosurg 2018 Oct 2;118:e10-e17. Epub 2018 Jun 2.

Division of Neurological Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA. Electronic address:

Background: Temporal bone tegmen defects may be associated with cerebrospinal fluid (CSF) otorrhea. A variety of techniques have been used for repair. We report our experience with skull base reconstruction for tegmen defects using either autologous or alloplastic grafts. Read More

J Neurosci Rural Pract 2018 Apr-Jun;9(2):226-231

Department of Medicine, AIIMS, Jodhpur, Rajasthan, India.

Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI).

Design: Prospective observational study.

Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. Read More

Otolaryngol Head Neck Surg 2018 Sep 24;159(3):543-552. Epub 2018 Apr 24.

4 Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.

Objectives (1) Compare lateral skull base (LSB) height/thickness in patients with spontaneous cerebrospinal fluid otorrhea (CSF), superior canal dehiscence (SCD), acoustic neuromas (AN), and otosclerosis (OTO). (2) Perform correlations between age, body mass index (BMI), sex, and LSB height/thickness. Study Design Case series with chart review. Read More

Neurosurg Focus 2018 Apr;44(4):E10

Department of Neurosurgery, Neurological Institute, and.

OBJECTIVE Despite the advances in skull base techniques, large petroclival meningiomas (PCMs) still pose a challenge to neurosurgeons. The authors' objective of this study was to describe a pretemporal trans-Meckel's cave transtentorial approach for large PCMs and to report the surgical outcomes. METHODS From 2014 to 2017, patients harboring large PCMs (> 3 cm) and undergoing their first resection via this procedure at the authors' institute were included. Read More

Int J Crit Illn Inj Sci 2017 Oct-Dec;7(4):231-235

Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.

Background: Otorhinolaryngological injuries following head trauma may be missed, overlooked, or forgotten in the acute phase resulting in worsened management outcomes. This study aims to report the epidemiology, clinical presentations, management, and outcomes of otorhinolaryngological injuries in head trauma with a view to creating awareness for early recognition and prompt treatment.

Patients And Methods: Head injured patients consecutively presenting over a 5-year period were prospectively studied for age, gender, otorhinolaryngological presentations, interventions, and outcome of interventions. Read More

World Neurosurg 2017 Dec 1;108:157-162. Epub 2017 Sep 1.

Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan.

Background: Skull base reconstruction is an essential technique for repairing cerebrospinal fluid (CSF) leakage. A reliable method for middle cranial fossa (MCF) reconstruction with minimal invasiveness has not been reported. An initial case of endoscopic MCF reconstruction with a subtemporal keyhole is described. Read More

J Neurosurg 2018 Jun 11;128(6):1880-1884. Epub 2017 Aug 11.

Neurosurgery, Temple University School of Medicine, Philadelphia, Pennsylvania.

OBJECTIVE Temporal lobe encephaloceles and cerebrospinal fluid otorrhea from temporal bone defects that involve the tegmen tympani and mastoideum are generally repaired using middle fossa craniotomy, mastoidectomy, or combined approaches. Standard middle fossa craniotomy exposes patients to dural retraction, which can lead to postoperative neurological complications. Endoscopic and minimally invasive techniques have been used in other surgeries to minimize brain retraction, and so these methods were applied to repair the lateral skull base. Read More

Otolaryngol Head Neck Surg 2017 05 7;156(5):924-932. Epub 2017 Feb 7.

2 Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati (UC) College of Medicine and Neurosensory Disorders Center at UC Gardner Neuroscience Institute, Cincinnati, Ohio, USA.

Outcome Objectives To (1) explore audiometric outcomes following use of a combined transmastoid/middle cranial fossa (TM-MCF) approach in the treatment of spontaneous cerebrospinal fluid (CSF) otorrhea and (2) determine the influence of dehiscence location and reconstructive methodology on audiometric outcomes. Study Design Case series with chart review. Setting Tertiary care center. Read More

No Shinkei Geka 2016 Dec;44(12):1053-1057

Department of Neurosurgery, Atami Tokoro Memorial Hospital.

Spontaneous cerebrospinal fluid(CSF)otorrhea is less common than CSF leakage caused by trauma, and rarely occurs in adults. We report an adult case of CSF otorrhea. A 71-year-old woman with no traumatic or otologic history was hospitalized due to bacterial meningitis. Read More

Radiol Clin North Am 2017 Jan;55(1):167-187

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Emory University Hospital, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA. Electronic address:

As the obesity epidemic grows in the United States, rhinorrhea and otorrhea from spontaneous cerebrospinal fluid (CSF) leaks secondary to untreated idiopathic intracranial hypertension are increasing in prevalence. CSF rhinorrhea and otorrhea should also be carefully evaluated in posttraumatic and postsurgical settings, because untreated CSF leaks often have serious consequences. The work-up, diagnosis, and characterization of a CSF leak can be complex, often requiring a multimodality approach to optimize surgical planning. Read More

Otol Neurotol 2017 01;38(1):66-72

*Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center †University of Texas Southwestern Medical School, Dallas, Texas.

Objective: Describe the diagnosis and management of spontaneous lateral skull base cerebrospinal fluid (CSF) leaks that originate from the posterior fossa.

Study Design: Retrospective case review.

Setting: Tertiary university hospital. Read More

Otol Neurotol 2016 12;37(10):1625-1629

*Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana†Division of Otolaryngology, Department of Surgery, School of Medicine and Public Health, The Univeristy of Wisconsin-Madison, Madison, Wisconsin‡Department of Otolaryngology-Head and Neck Surgery§Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Objective: To determine the efficacy and morbidity of repairing spontaneous cerebrospinal fluid (CSF) leaks with the middle cranial fossa (MCF) approach without the use of a lumbar drain (LD), as perioperative use of LD remains controversial.

Study Design: Retrospective review from 2003 to 2015.

Setting: University of Iowa Hospitals and Clinics and Indiana University Health Center. Read More

Acta Otolaryngol 2017 Feb 31;137(2):131-135. Epub 2016 Aug 31.

a Department of Otolaryngology, Head & Neck Surgery , Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing , Beijing , PR China.

Objective: To investigate the surgical treatment and related experience of lateral skull base lesions.

Methods: In a retrospective, clinical data analysis of 20 patients with lateral skull base diseases, 11 cases with temporal bone space-occupying lesions and intracranial invasion were treated by translabyrinthine surgery, mastoid cavity drainage, or transmastoid surgery to remove the lesion; two cases of cholesteatoma with destruction of tympanic cavity and tympanic sinus canopy with intracranial invasion were treated by extended radical mastoidectomy; seven cases with lateral skull base bone destruction with cerebrospinal fluid otorrhea caused by trauma and deformity were treated by translabyrinth and transmastoid repair.

Results: Eleven cases with temporal bone space occupying lesions were resected completely and were without recurrence after surgery. Read More

Acta Otorrinolaringol Esp 2017 Mar - Apr;68(2):86-91. Epub 2016 Aug 8.

Servicio de Otorrinolaringología, Hospital Universitario Donostia, San Sebastián, España.

Introduction: Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach.

Material And Methods: We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). Read More

Otolaryngol Head Neck Surg 2016 10 24;155(4):641-8. Epub 2016 May 24.

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Objectives: (1) To quantitatively assess the lateral skull base thickness in patients with superior semicircular canal dehiscense (SSCD) using a standardized and validated radiographic measure and to compare it with that of a population with spontaneous cerebrospinal fluid otorrhea (CSFO). (2) To analyze demographic and clinical factors associated with skull base thickness in the SSCD group.

Study Design: Case series with chart review. Read More

Otolaryngol Head Neck Surg 2016 Apr 23;154(4):707-14. Epub 2016 Feb 23.

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Objectives: (1) Correlate skull base thickness with perioperative outcomes for spontaneous cerebrospinal fluid (CSF) otorrhea. (2) Augment perioperative counseling of patients with abnormally thin skull bases.

Study Design: Case series with chart review. Read More

J Clin Neurosci 2016 Mar 24;25:111-5. Epub 2015 Dec 24.

Neurosurgery Department, Hadassah Medical Center, Jerusalem, Israel. Electronic address:

About 4% of all head injuries include skull base fractures. Most of these fractures (90%) are secondary to closed head trauma; the remainder are due to penetrating trauma. We reviewed the records from January 2006 through December 2008 of all patients older than 18 years of age who arrived at Soroka Medical Center in Be'er-Sheva, Israel, with skull base fractures following a traumatic brain injury (TBI). Read More

J Clin Neurosci 2016 Feb 16;24:124-7. Epub 2015 Oct 16.

Department of Neurological Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA; Department of Otolaryngology - Head & Neck Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers University, New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07103, USA. Electronic address:

The retrosigmoid transmeatal approach remains an important strategy in the surgical management of acoustic neuromas. Gross total resection of acoustic neuromas requires removal of tumor within the cerebellopontine angle as well as tumor involving the internal auditory canal (IAC). Drilling into the petrous bone of the IAC can expose petrous air cells, which can potentially result in a fistulous tract to the nasopharynx manifesting as cerebrospinal fluid (CSF) rhinorrhea. Read More

Curr Opin Otolaryngol Head Neck Surg 2015 Oct;23(5):341-7

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Purpose Of Review: This article aims to review relevant implications of obesity and associated comorbid conditions for the otology and neurotology surgical subspecialties.

Recent Findings: Both the incidence and prevalence of obesity are rising worldwide. This condition, along with its many associated comorbidities, can adversely affect the perioperative management of patients undergoing otologic and neurotologic procedures. Read More

Laryngoscope 2016 Feb 8;126(2):464-8. Epub 2015 Aug 8.

Department of Otology/Neurotology, Illinois Hospitals and Health Sciences System, Chicago, Illinois, U.S.A.

Objectives/hypothesis: The goals of this study are to: 1) investigate the urgency for repair of middle cranial fossa spontaneous cerebrospinal fluid (CSF) leaks in adults, and 2) review the literature and treatment recommendations for adult spontaneous CSF otorrhea.

Data Sources: 1) All patients who were referred to a tertiary center with spontaneous CSF otorrhea, exposed middle cranial fossa dura, or encephalocele from 2004 to 2015; and 2) landmark references on spontaneous CSF leaks

Review Methods: Electronic medical records of patients with a documented spontaneous CSF leak, exposed dura, or encephalocele were reviewed. Subjects were excluded if they had a congenital, traumatic, or iatrogenic CSF leak. Read More

J Maxillofac Oral Surg 2015 Jun 6;14(2):258-62. Epub 2014 May 6.

Department of Oral and Maxillofacial Surgery, Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Hezar-Jarib Ave., Isfahan, Iran.

Background: A number of patients with facial fractures have cerebrospinal fluid (CSF) leak that may result in meningitis and other central nervous system complications. Commonly, CSF leak occurs following trauma, but the etiology and pattern of this disorder are different from region to region. This study aims to evaluate the distribution of CSF leak in patients with maxillofacial fractures in Isfahan province, Iran. Read More

Otolaryngol Head Neck Surg 2015 Jan 1;152(1):172-9. Epub 2014 Dec 1.

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Objectives: (1) To describe a validated algorithm for measuring tegmen thickness on computed tomography scans. (2) To compare the tegmen thickness in 3 groups: patients with spontaneous cerebrospinal fluid (CSF) leaks, obese controls, and nonobese controls.

Study Design: Retrospective review. Read More

J Neurol Surg B Skull Base 2014 Aug 2;75(4):279-87. Epub 2014 May 2.

Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy.

Objectives To describe our departmental experience in the surgical repair of tegmen tympani defects using a combined transmastoid/minicraniotomic approach. Design Retrospective review of videos from surgery and patients' charts. Setting Tertiary university referral center. Read More

Jpn J Radiol 2014 Jul 23;32(7):437-40. Epub 2014 Apr 23.

Department of Radiology, Bezmialem Vakif University School of Medicine, Adnan Menderes blv, Fatih, Istanbul, Turkey,

During the follow-up of recurrent pneumonia in a 9-month-old girl, rhinorrhea with discharge of a positional and intermittent nature was discovered. Radiological assessment was requested to detect any skull base openings and cerebrospinal fluid (CSF) leakage. T2-weighted MR cisternography showed bilateral inner ear dysplasia, communication of the internal auditory canal with the vestibule, and effusion in the right middle ear. Read More

Iran J Otorhinolaryngol 2014 Apr;26(75):119-23

Department of Otorhinolaryngology, Ghaem Hospital,Faculty of Medicine,Mashhad University of Medical Sciences, Mashhad,Iran.

Introduction: Leakage of cerebrospinal fluid in the skull base may be accompanied with recurrent meningitis. The site of leakage may either be anterior (in the nose and paranasal sinuses) or posterior (in the temporal bone). Various imaging techniques can be used to precisely locate the point of leakage but despite all the advances in imaging techniques there are still some rare cases in which the surgeon can't be sure on the management approach before the beginning of surgery. Read More

J Neurol Surg B Skull Base 2014 Apr 11;75(2):117-24. Epub 2013 Dec 11.

Department of Otolaryngology Head and Neck Surgery, University of Kansas, Kansas City, Kansas, United States.

Objective The types of otogenic cerebrospinal fluid (CSF) fistulae were previously classified into defects through, adjacent to, or distal to the otic capsule. This article presents cases of the three different types of spontaneous CSF fistulae and reviews pertinent literature. We examine the management of the different types of otogenic CSF leaks with modern audiovestibular testing, imaging, and surgical techniques. Read More

Int J Oral Maxillofac Surg 2014 Aug 28;43(8):951-4. Epub 2014 Mar 28.

Senri Critical Care Medical Center, Saiseikai Senri Hospital, Suita, Osaka, Japan.

Maxillofacial fractures are often associated with blunt head injuries, of which skull base trauma is a common component. However, most oral and maxillofacial surgeons do not provide definitive management of temporal bone fractures involving the skull base and their sequelae. Persistent cerebrospinal fluid (CSF) leakage that is refractory to conservative measures usually requires surgical closure to decrease the risk of meningitis. Read More

Otol Neurotol 2014 Feb;35(2):344-7

*Department of Otolaryngology, †Department of Neurological Surgery, ‡Center for Skull Base Surgery, and §Departments of Otolaryngology, Neurological Surgery, Communication Sciences and Disorders, Director Ear and Hearing Center, Division of Otology/Neurotology, University of Pittsburgh Medical Center, Suite 500 Eye and Ear Institute, Pittsburgh, Pennsylvania, U.S.A.

Objective: To assess intracranial pressure (ICP), body mass index (BMI), surgical repair, and cerebrospinal fluid (CSF) diversion in patients presenting with spontaneous CSF otorrhea.

Study Design: Retrospective series review.

Setting: Tertiary referral center. Read More

J Neurol Surg B Skull Base 2013 Apr 22;74(2):103-7. Epub 2013 Jan 22.

Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, United States.

Spontaneous cerebrospinal fluid (CSF) otorrhea due to tegmen tympani defects can result in hearing impairment and predispose to meningitis. Seizures or neurological deficits are additional risks, particularly when associated with an encephalocele. Surgical repair of the dural defect through a middle cranial fossa (MCF) approach is a treatment option under these circumstances. Read More

Laryngoscope 2014 May 13;124(5):1204-8. Epub 2013 Dec 13.

Department of Otolaryngology-Head & Neck Surgery, Cincinnati, Ohio, U.S.A; Mayfield Clinic, Cincinnati, Ohio, U.S.A.

Objectives/hypothesis: Spontaneous occurrence of otogenic cerebrospinal fluid (CSF) effusion is now far more prevalent than causes related to infections, prior surgeries, or trauma-trends that may be increasing because of higher rates of obesity and improved diagnostic awareness. In our patient cohort with spontaneous CSF effusion, we report its association with obesity and audiological findings before and after surgery.

Study Design: Retrospective study. Read More

Laryngorhinootologie 2013 Dec 30;92(12):823-7. Epub 2013 Sep 30.

Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg.

Background: The aim of this study was to analyze complications after surgery for vestibular schwannoma (VS) via the middle cranial fossa (MCF) approach.

Patients And Methods: 112 consecutive patients have been operated on via MCF approach in our department between October 2005 and March 2011. Postoperative complications have been registered during hospital stay as well as during outpatient follow-up. Read More

Acta Med Iran 2013 Aug 7;51(7):467-71. Epub 2013 Aug 7.

Department of Neurosurgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

In this study, we examined the role of early acetazolamide administration in reducing the risk of cerebrospinal fluid (CSF) leakage in patients with a high risk of permanent CSF leakage. In a randomised clinical trial, 57 patients with a high risk of permanent CSF leakage (rhinorrhea, otorrhea, pneumatocele or imaging-based evidence of severe skull-base fracture) were analysed. In the experimental group, acetazolamide, at 25 mg/kg/day, was started in the first 48 hours after admission. Read More

Neurol Med Chir (Tokyo) 2013 ;53(4):217-20

Department of Neurosurgery, Saitama Medical Center Jichi Medical University, Saitama 330-8503, Japan.

Late onset cerebrospinal fluid (CSF) leakage, such as rhinorrhea or otorrhea, is a rare complication of closed head injury. We encountered two cases of delayed CSF leakage more than 10 years after head injury. In both cases, surgical treatments were performed using intradural approaches, and the dural defects were closed with viable pedicled flaps. Read More

Otol Neurotol 2012 Oct;33(8):1412-7

Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York, USA.

Objective: Temporal bone encephaloceles and cerebrospinal fluid (CSF) otorrhea can lead to life-threatening sequelae such as meningitis and cerebritis. Obesity has been associated with spontaneous CSF leaks. We wished to determine if there were differences in the body mass index (BMI) of patients with spontaneous temporal bone encephaloceles/CSF leaks and nonspontaneous temporal bone encephaloceles/CSF leaks to help determine if obesity may be associated with their development. Read More

Otolaryngol Head Neck Surg 2012 Dec 11;147(6):1120-4. Epub 2012 Aug 11.

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390-9035, USA.

Objective: To determine the prevalence of superior semicircular canal dehiscence (SCD) in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.

Study Design: Case series with chart review.

Setting: Tertiary care referral center. Read More

Emerg Med J 2013 Sep 12;30(9):777-8. Epub 2012 Jul 12.

Department of Emergency, St. Vincent's University Hospital, Elm Park, Dublin 4, Dublin, Ireland.

Neurosurg Focus 2012 Jun;32(6):E8

Department of Neurosurgery, Louisiana State University Health Sciences Center-Shreveport, Louisiana 71130-3932, USA.

Object: Methods for repairing middle fossa CSF (MFCSF) leaks have varied and yielded mixed results. The objective of this study was to evaluate the safety and durability of the authors' repair technique using a novel combination of 3 synthetic materials.

Methods: The authors performed a retrospective case review of patients treated for CSF leaks between January 2009 and September 2011. Read More

Neurosurg Focus 2012 Jun;32(6):E4

Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport, Shreveport, Louisiana 71130-3932, USA.

Object: Various factors have been reported in literature to be associated with the development of posttraumatic meningitis. There is a paucity of data regarding skull fractures and facial fractures leading to CSF leaks and their association with the development of meningitis. The primary objective of this study was to analyze the US Nationwide Inpatient Sample (NIS) database to elucidate the factors associated with the development of posttraumatic meningitis. Read More

Pediatr Neurosurg 2011 23;47(4):299-302. Epub 2012 Mar 23.

Department of Pediatric Hematology-Oncology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Objective And Importance: Gorham-Stout disease is a rare entity characterized by vascular proliferation causing local destruction of bone tissue. Owing to its low incidence and variable clinical presentation, the diagnosis requires a high degree of awareness by the clinician.

Clinical Presentation: We present the case of a 2-year-old boy diagnosed of Gorham-Stout syndrome with involvement of the temporal bone and secondary cerebrospinal fluid (CSF) leakage. Read More

Am J Otolaryngol 2012 Sep-Oct;33(5):556-61. Epub 2012 Mar 3.

Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, CA 92868, USA.

Purpose: The aim of the study was to evaluate various presentations and treatment options for spontaneous cerebrospinal fluid (CSF) leakage originating in the temporal bone.

Materials And Methods: Clinical data and imaging results for 18 ears (15 patients) presenting with spontaneous CSF leakage originating in the temporal bone were reviewed. Average follow-up period was 13. Read More

World Neurosurg 2012 May-Jun;77(5-6):713-24. Epub 2011 Nov 7.

Department of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.

Objective: To assess the advantages and limitations of the endoscopic endonasal approach to anterior skull base meningiomas, a minimally invasive approach that avoids extensive bone drilling, brain retraction, and manipulation of nerves and critical vessels, versus open transcranial surgery.

Methods: A MEDLINE (2000-2010) search was performed to identify series for either olfactory groove meningiomas or tuberculum sellae (TS) or planum sphenoidale meningiomas. Statistical analyses of categorical variables such as extent of resection, morbidity, and visual outcome were performed using χ(2) and Fisher exact tests. Read More

Otol Neurotol 2011 Dec;32(9):1522-4

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Objective: To determine the efficacy of lumbar drainage in managing cerebrospinal fluid (CSF) leak after lateral skull base surgery.

Study Design: Retrospective case review.

Setting: Academic tertiary referral center. Read More

Otolaryngol Head Neck Surg 2011 Oct 9;145(4):689-93. Epub 2011 Jun 9.

Department of Otolaryngology-Head and Neck Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Meningitis and cerebrospinal fluid (CSF) leak are serious complications of skull base surgery, but whether postoperative CSF leak increases the risk of meningitis is unknown.

Objective: To evaluate any association between meningitis and CSF leak after open or endoscopic skull base resection.

Study Design And Setting: A retrospective case series with chart review in a tertiary care university-affiliated medical center. Read More

Clin Radiol 2010 Oct;65(10):832-41

Neuroradiology Department, Kings College Hospital, Denmark Hill, London, UK.

Skull-base cephalocoeles and cerebrospinal fluid (CSF) leaks may be congenital, spontaneous, or secondary. A classification of congenital lesions is formulated and the imaging features are illustrated. The concept of spontaneous skull-base CSF leaks and the significance of aberrant arachnoid granulations in imaging these patients are explored. Read More

West Indian Med J 2009 Sep;58(4):362-6

Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica.

A CSF leak results from a defect in the dura and skull base. Due to the risk of potentially devastating central nervous system infection, it is an important entity. Timely diagnosis of CSF leaks is crucial. Read More

AJNR Am J Neuroradiol 2010 Jan 17;31(1):71-5. Epub 2009 Sep 17.

Department of Radiology, Division of Neuroradiology, Bakirkoy State Hospital for Research and Training in Neurology, Neurosurgery, and Psychiatry, Istanbul, Turkey.

Background And Purpose: Radiologic identification of the location of the CSF leakage is important for proper surgical planning and increases the chance of dural repair. This article describes our experience in analyzing clinically suspected cranial CSF fistulas by using MR imaging combined with the intrathecal administration of a gadolinium-based contrast agent.

Materials And Methods: A total of 85 consecutive patients with suspected CSF fistulas who presented with persistent or intermittent rhinorrhea or otorrhea lasting for more than 1 month between 2003 and 2007 were included in this study. Read More

Clin Exp Otorhinolaryngol 2009 Jun 29;2(2):97-9. Epub 2009 Jun 29.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Korea.

Osteoradionecrosis of the temporal bone is a very rare but potentially lethal complication of radiotherapy for head and neck or skull base tumors. Only two cases of osteoradionecrosis of the temporal bone complicating cerebrospinal fluid (CSF) otorrhea have been reported in the literature. This report describes a case of CSF otorrhea and osteoradionecrosis of the temporal bone in a patient with meningioma who was treated with tympanomastoid surgery and autologous fat obliteration in the mastoid. Read More