CSF Leak Management for the General Practitioner 2.0

PROGRAM DESCRIPTION: Cerebrospinal Fluid (CSF) leaks occur when there is an open communication between the intra-dural compartment and an extradural location. Diagnosis and management depend on: leak location, etiology, presenting symptoms. Etiologies include trauma, iatrogenic, tumors, and infections. Spontaneous and idiopathic presentations are often encountered by ENTs and may be associated with idiopathic intracranial hypertension (IIH). CSF leaks present with a range of clinical presentations making diagnosis a challenge. CSF leaks lead to life-threatening complications if untreated,such as meningitis. Practitioners face several challenges in identifying and working up CSF leaks:
- Heterogeneous clinical presentation overlaping with common otolaryngic disorders
- Symptom intermittency
- Selecting and implementing proper diagnostic testing.
- Localization of small CSF leaks
- Management of comorbid conditions such as IIH
- Understanding the latest management
This expert panel will guide ENTs through these challenges using a case study format to frame the work-up and management. The panel will discuss definitive treatment options from bedrest to direct surgical reconstruction and when to involve other specialists in a multi-disciplinary care team.The panel will review new CSF + IIH guidelines and promising treatments.

Goals: This panel will focus on helping the general ENT identify and work up CSF leaks involving the anterior and lateral skull base. We will use cases to review the natural history for multiple CSF leak etiologies and key elements of pathophysiology about clinical workup and diagnosis. The panel will use a case-based format to help the audience construct a practical framework for detecting, diagnosing, and treating CSF leaks, giving special focus to the prevention of recurrence and minimizing treatment complications.

Audience: Designed for general ENTs who may encounter various presentations of CSF leaks in the anterior and lateral skull base. Attention will be given to both identifying de novo cases and properly assessing and managing iatrogenic presentations.