Introduction Major craniofacial trauma can result in numerous comminuted fractures of the frontal and facial bones, and when in-driven, multiple lacerations of the dura mater, laceration and contusion of the underlying frontal lobes, and cerebrospinal fluid (CSF) leak in the…
Introduction Classification Cerebrospinal fluid (CSF) rhinorrhea results from a breach in the skull base, leading to communication between the subarachnoid space and nasal cavity. The accurate classification of CSF leak etiology is paramount because this information often guides management. An…
Introduction Patients with skull base fractures often have accompanying orbital and intracranial injuries, which warrant attention on dedicated imaging evaluation. Computed tomography (CT) is the modality of choice for evaluating anterior skull base fractures and associated intracranial hemorrhage and localizing…
Introduction Cerebrospinal fluid (CSF) leaks may occur in about 2% to 4% of skull base fractures. , CSF leaks are five to six times more likely to occur in the anterior skull base than the rest of the cranial fossa.…
Introduction Despite significant advances in endoscopic surgical training, technique, and instrumentation, endoscopic sinus and skull base surgery can result in inadvertent skull base injury with subsequent cerebrospinal fluid (CSF) leak a small percentage of the time. Iatrogenic CSF leaks are…
Introduction Cerebrospinal fluid (CSF) leaks arising from the posterior fossa are uncommon and are usually a result of abnormal communications between the subarachnoid space and air-containing spaces in the temporal bone. Causes of these abnormal communications include trauma, surgical defects,…
Introduction The skull base represents the inferior segment of the cranium and traditionally is arbitrarily divided into three segments known as the anterior, middle (MCF), and posterior cranial fossae. From a surgical perspective, relevant neurovascular and anatomic functional structures must…
Introduction It is essential for otolaryngologists and neurosurgeons to have a thorough understanding of the complex anatomy of the anterior skull base. This knowledge allows surgeons to navigate the different intranasal surgical approaches that can be used to manage sinonasal…
Introduction The discovery, physiology, and flow of the mysterious “liquor cerebrospinalis” has been an ongoing debate and topic of inquiry which continues in the present time. The great Greek physician Hippocrates (460–370 bc ) embraced the ancient theory of “humoralism”…
Introduction The radiographic approach to the assessment of skull base cerebrospinal fluid (CSF) leaks, whether traumatic, iatrogenic, congenital, secondary to underlying increased intracranial pressure, or otherwise spontaneous, can be aimed at attempting to initially answer the question of whether a…