POSTOPERATIVE OCCULT OTOGENIC CEREBROSPINAL FLUID LEAKAGE IN TEMPORAL-BASAL BRAIN TUMOR SURGERY: PATHOPHYSIOLOGY, DIAGNOSIS, AND MANAGEMENT STRATEGIES

Abstract

Postoperative cerebrospinal fluid (CSF) leakage remains one of the most severe complications in skull base neurosurgery and is associated with a high risk of intracranial infectious complications. Occult otogenic CSF leakage is a rare but clinically significant condition that often mimics nasal liquorrhea and may remain undiagnosed in the early postoperative period. The present study analyzes the etiopathogenetic mechanisms, diagnostic approaches, and therapeutic strategies for postoperative occult otogenic CSF leakage in patients undergoing temporal-basal brain tumor surgery. Clinical, biochemical, and radiological data from patients with postoperative CSF leakage were analyzed, emphasizing the role of temporal bone fractures and dural defects as primary etiological factors. Conservative treatment combined with lumbar drainage and local otorhinolaryngological therapy demonstrated high efficacy in eliminating CSF leakage and preventing infectious complications. Early diagnosis and targeted preventive neurosurgical strategies are crucial to improving postoperative outcomes in patients with cranial base tumors.