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Article
June 1989

Cerebrospinal Fluid Leakage Complicating Orbital Exenteration

Author Affiliations

From the Oculoplastic/Orbital Service, Scheie Eye Institute, Hospital of the University of Pennsylvania, Philadelphia (Dr Wulc), the Department of Ophthalmology, University of Michigan, Ann Arbor (Dr Adams), and the Department of Ophthalmology, University of Arizona, Tucson (Dr Dryden).

Arch Ophthalmol. 1989;107(6):827-830. doi:10.1001/archopht.1989.01070010849027
Abstract

• In three cases of cerebrospinal fluid leakage complicating orbital exenteration, leakage occurred intraoperatively following relatively low-power (0 to 25 W), high-frequency monopolar cautery to the orbital roof. Six cadaver orbits and 25 dried skulls were examined to investigate possible causes of intraoperative cerebrospinal fluid leakage. In this experimental model, monopolar cautery to the orbital roof did not cause cerebrospinal fluid leakage; however, cautery to preexistent foramina or experimentally created defects in the orbital bones did. In exenteration, monopolar cautery may transmit thermal energy through extant body defects in the orbital roof directly to the dura, resulting in its disruption. These defects may be congenital, tumor related, or iatrogenic. Alternative methods of hemostasis should probably be employed to control bleeding that occurs along the orbital roof during exenteration.

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