Procedure

CSF Otorhinorrhea Repair- Ear Nose And Throat (ENT)

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CSF (cerebrospinal fluid) otorhinorrhea repair is a treatment method that prevents the flow of CSF from nose or ear.

What is CSF Otorhinorrhea?

Head trauma, surgical errors, bone infections, or tumors can cause leakage of CSF through a hole in the skull. In some cases, the leakage may occur due to an unknown cause. Depending on the location of the hole, CSF may leak from the nose or ear. Though rare, CSF leakage can be fatal. Thus, it requires urgent medical care.   

Diagnosis of Otorhinorrhea

Before starting the treatment, it is necessary to diagnose the condition. The diagnosis includes:

Laboratory tests

  • Test for glucose levels in the fluid. CSF has a higher blood glucose level than the nasal secretion. Thus, testing for blood glucose helps identify if the fluid is CSF.
  • Beta2 transferrin test. Only CSF contains beta2transferrin. Thus, if the fluid obtained from the nose or ear contains beta2transferrin, it suggests CSF leakage.

Imaging tests

High resolution computed tomography (HRCT) scan

HRCT scan produces images of bones and tissues in the skull. They help identify and locate the site of leakage.

Magnetic resonance imaging (MRI)

MRI may not be necessary if the beta2transferrin test is positive and CT shows defects in the skull. However, the doctor may order MRI to locate the exact site of leakage.

CSF Otorhinorrhea Repair: Learn the Basics

CSF otorhinorrhea repair can be either conservative or surgical. Conservative treatment includes rest, avoidance of straining, and drainage of fluid through a hole made in the lower back.

To avoid strain, the doctor may ask you to avoid strenuous activities. For example, coughing, sneezing and lifting heavy weights. If you have constipation, you may be given medications to soften the stools.

If conservative treatment does not work, the doctor may order surgery. During the surgery, a surgeon closes the hole in the base of the skull with tissues obtained from other parts of the body. Besides, they may use synthetic materials such as bone wax or DuraGen®.

Sources: 

  • https://www.utmb.edu/otoref/Grnds/CS-Leak-021002/CF-leak-021002.pdf
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3936553/
  • https://www.nejm.org/doi/full/10.1056/NEJMicm1300806
  • https://www.ncbi.nlm.nih.gov/pubmed/19029865
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3450118/pdf/12070_2009_Article_26.pdf
About the Author:
Shailesh Sharma is a registered pharmacist and medical content writer from Nepal. He enjoys digging into latest findings of research and strongly believes in evidence-based health information. He graduated from Pokhara University School of Health and Allied Sciences and was engaged in clinical pharmacy and academia in various regions of Nepal for almost 9 years. Shailesh also serves as Project Manager of Graduate Pharmacists’ Association, Nepal (GPAN).
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