Cerebrospinal fluid leak occurred in 10.6% of 2,273 retrosigmoid surgeries, 9.5% of 3,118 translabyrinthine surgeries, and 10.6% of 573 middle fossa surgeries. The type of cerebrospinal fluid leak was not associated with surgical approach. Meningitis was significantly associated with cerebrospinal fluid leak (p < 0.05). Age and tumor size were not associated with cerebrospinal fluid leak.

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The direct communication of peritubal cells with the bony eustachian tube may play a role in the development of persistent cerebrospinal fluid rhinorrhea after cerebellopontine angle surgery.

Incisional cerebrospinal fluid leakage responded well to local management and lumbar drainage. Rhinorrhea often necessitated surgical intervention. No specific reoperation techniques correlated exclusively with better reoperation outcomes. The transaural/transnasal approach presents an alternative for surgical management of cerebrospinal fluid rhinorrhea.

The authors describ e a prospective p ilot study design ed to investigat e the use oftop ical nasal antifungal spray in addition tosys temic steroids anditracona zole in the treatment ofallerg icfu ngal sinusitis. Sixteenpatients with a history of allerg icfungal sinusitis weregivenfluconazole nasal spray andfo llowed fo r 3 nionths. Stabilizati on or improvement ofdisease without significant side ejJects was observed in J2 ofthe J6 p atients who were treated with this protocol. These results indi cat e that topicalflu conazole app lication may help patients with all ergic fungal sinusitis; ltowe vet; a larg er multicenter study with longer patient fo llow-up is required to validate these initialfindings. Th e Osler Institute Otolaryngology Board Review Courses for Written Exams • Self-dir ected study questions and answers • 6-d ay semin ar with lectu re-note syllabus • Multiple-choice question discussions

To determine the cause of nasal valve obstruction in a series of patients requiring surgical correction, to evaluate the efficacy of our surgical techniques, and to assess the cosmetic effect of nasal valve repair. Methods: Retrospective review of 53 consecutive cases involving adult patients who underwent nasal valve reconstruction over an 8-year period. The preoperative symptom severity, cause of nasal valve obstruction, preoperative photographs, anatomical findings at the time of surgery, and reconstructive techniques were reviewed. Postoperative photographs and resolution of symptoms were analyzed. Results: The most common cause of nasal valve obstruction was previous rhinoplasty (79%), followed by nasal trauma (15%) and congenital anomaly (6%). Spreader grafts were used in 42 patients (79%), and alar batten grafts were

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