الفهرس 
Anatomical backgroundOnly 14 pages are availabe for public view
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Abstract
Objective:to review, revise,and analyze the success of different ways of management of postoperative CSF leak in cranial surgeries and recommending best way of this management.
Methods: Fifteen study were systematically reviewed depending on electronic databases including studies between 2000 and 2016, mainly analytic studies and well conducted descriptive studies of good quality. Excluded studies were Case reports or case series with less than 10 patients, Technical notes, letters, and comments.
Results: The failure rates in cases of lumbar drain before surgery 5%, as well as cases of lumbar drain after surgery 5%. The cases of failed intraoperative repair were 67 (6.9%) which needed a second surgery. two cases at a rate of 1.3% of the postoperative repair were in need for a third surgery. The failure rate in cases of conservative treatment was 1.7%.
Conclusion:Treatment of a CSF leak always starts with planning before the surgery according to each case. Any case with intraoperative leak should be repaired. After surgery start conservative measures like bed rest, pressure dressings and i.v. antibiotics since this resulted in a high rate of spontaneous closure of the leak. The next step would be the placement of a lumbar drainage. If these non-surgical procedures are not successful, surgical reexploration is indicated. However, when performing revision surgery it is very important to seal pneumatized air cells meticulously to prevent recurrence.
Key words:“postoperative, CSF leak, CSF fistula, management, cranial, skull base surgeries, CSF rhinorrhea, CSF otorrhea”