I have repaired one that was said to have followed septoplasty by the
neurosurgeons and it was in the sphenoid! I would question why it was not
explored and sealed endoscopically rather than neurosurgically, which in
itself would have been a lot less invasive and simpler.

It should have come on immediately after the surgery. CSF fistule can occur
spontaneously as well.

I think that you could question the neurosurgeons in this regard who do not
seem to be aware that the results from extracranial repair are just as good
if not better than from intracranial repair. This leak may have been ideal
to do this way. Also see ANZJS in May where I have reported my limited
experience of sealing them extracranially.


Jim





At 10:49 PM 9/11/98 +1000, you wrote:
>I've recently seen a patient who had a CSF leak, with a fistula in the
cribriform plate, confirmed by Neurosurgical exploration.
>
>She thinks it is due to a previous Septoplasty, with no ethmoid surgery,
and wants to sue the ENT surgeon.  
>
>Has anyone ever seen or heard of this?
>--
>*****************************************************************
>Mr. Stephen Kleid    FRACS   ENT/HN Surgeon
>26 Balaclava Rd,  St. Kilda,  Vic  3183,  AUSTRALIA
>Ph    +61 3 9526-5527
>Fax   +61 3 9525-9544
>e-mail    [log in to unmask]
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>
>
>



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