Cerebrospinal rhinorrhea: extracranial surgical repair.

Cerebrospinal rhinorrhea is an uncommon complication of head trauma or of diverse types of intracranial diseases. Because of the risk of meningitis, this condition warrants immediate attention. If the leak fails to stop spontaneously in a short time, the precise site of the leak must be ascertained and surgical repair attempted. For the past 50 years craniotomy has been the principal operative approach; however, this method carries the risk of significant morbidity and protracted hospital stays, as well as a disappointing incidence of persistent leak. During the past decade extracranial operations for dural repair have been devised, and experience in the management of patients by a variety of such procedures illustrates the success of these operations.