Contemporary Trends in the Management of Posttraumatic Cerebrospinal Fluid Leaks

Mourad, Moustafa; Inman, Jared C.; Chan, David; Ducic, Yadranko

doi:10.1055/s-0036-1584890

Cited by 19 publications

(21 citation statements)

References 68 publications

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“…When suspecting a CSF leak, we must postpone surgical closure of the nasal vault fractures because the maneuvers can aggravate the lesions in the skull base. The CT scan confirms the fractures at the level of the nasal and ethmoid bones [33].…”

Section: Nasal-orbital-ethmoid Complex Fracturesmentioning

confidence: 56%

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

Vrînceanu¹,

Bănică²,

Dumitru³

2021

Trauma and Emergency Surgery - The Role of Damage Control Surgery

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Midfacial trauma is never an immediate therapeutic emergency excepting cases with nasal bleeding and risk of aspiration or requiring a permeable airway that will allow intubation when appropriate. The patient with polytraumas and midfacial fractures who needs ear, nose, and throat (ENT) or oral and maxillofacial (OMF) surgery should be reassessed at 24 and 48 hours to determine the optimal operating time. The surgical indication should be established according to esthetic and functional deficits. We consider that the optimal operative moment for the lesions of the midface is at 4-5 days after the trauma, under the conditions of a stable hemodynamic, respiratory, and afebrile patient. We propose the schematic presentation of the principles of diagnosis and treatment for midface trauma. We will discuss also some aspects of midfacial trauma during coronavirus disease-2019 (COVID-19) pandemic conditions. We must assume every patient with polytrauma as a COVID-19-positive patient. So, it is necessary to have a special circuit for a suspect COVID-19 polytrauma patient between emergency room (ER) department, operating room, and intensive care unit (ICU). All medical team must wear high-level personal protective equipment (PPE) during emergency treatment of a craniofacial trauma in the context of polytrauma until we get the result of RT-PCR testing.

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Section: Nasal-orbital-ethmoid Complex Fracturesmentioning

confidence: 56%

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

Vrînceanu¹,

Bănică²,

Dumitru³

2021

Trauma and Emergency Surgery - The Role of Damage Control Surgery

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“…These include breakage of the swab into the nose, epistaxis, and CSF leak. The concern for CSF leak is significant, as 10%–25% of patients with traumatic CSF leaks will develop meningitis 5 …”

Section: Discussionmentioning

confidence: 99%

“…The concern for CSF leak is significant, as 10%-25% of patients with traumatic CSF leaks will develop meningitis. 5 CONCLUSION CSF leak should be considered in patients with watery rhinorrhea or salty or metallic taste postnasal drip following an NP swab. This case highlights the need for education of proper NP swab technique for healthcare providers and education of the signs and symptoms of CSF rhinorrhea for patients.…”

Section: Discussionmentioning

confidence: 99%

CSF Leak After COVID‐19 Nasopharyngeal Swab: A Case Report

et al. 2021

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The nasopharyngeal swab has been used with increased frequency since the beginning of the COVID‐19 pandemic. Little has been written in the literature regarding the complications arising from this procedure, as it is generally accepted as safe. In this report, we describe a case in which a young woman sustained a traumatic skull base injury during a nasopharyngeal swab for COVID‐19. We then discuss the subsequent treatment and outcome. This case demonstrates the potential for significant complications arising from this widespread procedure and the necessity for awareness of these potential complications. Laryngoscope , 2021

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“…Often, postoperative CSF leaks will resolve within a few days with conservative management including elevation of the head of the bed and sinus precautions (stool softeners, no sneezing, no bending over). 28 Intracranial pressure should be maintained within a normal range (< 20 mm Hg). 1 Occasionally, acetazolamide can be given or a lumbar drain or ventriculostomy be placed to decrease intracranial pressure and allow healing and sealing of the fistula.…”

Section: Acute Complicationsmentioning

confidence: 99%

“…1 Occasionally, acetazolamide can be given or a lumbar drain or ventriculostomy be placed to decrease intracranial pressure and allow healing and sealing of the fistula. 28 A persistent leak requires surgical closure, however, to mitigate the risk of meningitis. 4 Elevated intracranial pressure can also contribute to bone resorption and poor healing at the craniotomy site.…”

Section: Acute Complicationsmentioning

confidence: 99%

Management of Skull Fractures and Calvarial Defects

et al. 2019

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Scalp and calvarial defects can result from a myriad of causes including but not limited to trauma, infection, congenital malformations, neoplasm, and surgical management of tumors or other pathologies. While some small, nondisplaced fractures with minimal overlying skin injury can be managed conservatively, more extensive wounds will need surgical repair and closure. There are many autologous and alloplastic materials to aid in dural and calvarial reconstruction, but no ideal reconstructive method has yet emerged. Different reconstructive materials and methods are associated with different advantages, disadvantages, and complications that reconstructive surgeons should be aware of. Herein, we discuss different methods and materials for the surgical reconstruction of calvarial defects.

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Contemporary Trends in the Management of Posttraumatic Cerebrospinal Fluid Leaks

Cited by 19 publications

References 68 publications

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

Diagnosis and Treatment of Midface Trauma in the Context of Polytrauma: Characteristics during COVID-19 Pandemic Conditions

CSF Leak After COVID‐19 Nasopharyngeal Swab: A Case Report

Management of Skull Fractures and Calvarial Defects

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