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عمومی::
همراه
Because ESS is associated with altered CSF circulation dynamics,37 treatment of nontraumatic CSF rhinorrhea, which has a demonstrated association with ESS, should include con- sideration of the concomitant diagnosis of ESS as well as the potential clinical impact of ESS.
Often CSF rhinorrhea is the presenting symptom of a meningocele or meningoencephalocele, but CSF rhinor- rhea is not a concomitant finding in many patients with con- firmed meningoceles (or meningoencephaloceles).
MR will also identify an empty sella, a finding that suggests the concomitant etiologic diagnosis of ESS.
Next, the defect site must be prepared for grafting, and bipolar cautery laser may be used to fulgurate a concomitant meningoencephalocele; a meningoencephalocele must never be reduced by simply pushing it intracranially.
The reported incidence of meningitis in patients with a posttraumatic CSF fistula varies greatly (2% to 50%).82-84 Multiple factors that include the duration or delayed onset of CSF leakage, site of the fistula, and concomitant infections seem to affect the occurrence of meningitis.
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