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Management of the Postoperative Leak

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Skull Base Reconstruction

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Abstract

Endoscopic endonasal skull base surgery is a commonly used approach for a wide variety of neoplastic pathology. Reconstruction of the subsequent skull base defect is a critical component of the procedure and is infrequently complicated by postoperative cerebrospinal fluid leak. Many patient and surgical characteristics influence the rate at which this complication occurs. Once suspected, rapid diagnosis and treatment must be employed to decrease the risk of bacterial meningitis. Physical exam including nasal endoscopy and a variety of imaging modalities are available for diagnostic and localization purposes. No optimal paradigm currently exists for the management of postoperative CSF leaks, but surgical revision is considered the mainstay of treatment with an option of adjuvant lumbar drainage and acetazolamide therapy in select patient populations.

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Authors and Affiliations

  1. Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Duncan C. Watley, Nyall R. London & Nicholas R. Rowan

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  1. Duncan C. Watley
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  2. Nyall R. London
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  3. Nicholas R. Rowan
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Correspondence to Nicholas R. Rowan .

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Editors and Affiliations

  1. Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Irvine, CA, USA

    Edward C. Kuan

  2. Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, USA

    Bobby A. Tajudeen

  3. Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Irvine, CA, USA

    Hamid R. Djalilian

  4. Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Irvine, CA, USA

    Harrison W. Lin

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Watley, D.C., London, N.R., Rowan, N.R. (2023). Management of the Postoperative Leak. In: Kuan, E.C., Tajudeen, B.A., Djalilian, H.R., Lin, H.W. (eds) Skull Base Reconstruction . Springer, Cham. https://doi.org/10.1007/978-3-031-27937-9_29

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