Diagnosis and treatment of frontobasal cerebrospinal fluid fistulas [Diagnostik und Therapie von frontobasalen Liquorfisteln]

摘要

Independent of its origin a frontobasal cerebrospinal fl uid (CSF) fi stula is characterized by an open connection between the intracranial space with the outside world (usually the nose and paranasal sinuses). It leads to loss of CSF and is associated with a signifi cant risk of developing meningitis for the patient during further life. Precise knowledge of possible aetiologies, clinical symptoms, current diagnostic options and surgical strategies are essential for the detection and successful management of frontobasal CSF fi stulas. This article summarizes aetiology and clinical signs of frontobasal CSF fi stulas. Further, laboratory tests to analyse fl uid samples for cerebrospinal fl uid as well as radiological and endoscopic investigation methods aiming to localize a CSF-fi stula are presented. Finally, surgical techniques to close a frontobasal CSF fi stula are explained.