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Clinical Note
March 2009

Endoscopic Management of Idiopathic Spontaneous Skull Base Fistula Through the Clivus

Author Affiliations

Author Affiliations: Department of Otorhinolaryngology, Georges Pompidou European Hospital, University of Paris–Descartes, Faculty of Medicine, Paris, France (Drs Elrahman, Malinvaud, N. A. Bonfils, Daoud, Mimoun, and P. Bonfils); and Faculty of Medicine, Benha University, Benha, Egypt (Dr Elrahman).

Arch Otolaryngol Head Neck Surg. 2009;135(3):311-315. doi:10.1001/archoto.2008.550

Cerebrospinal fluid (CSF) is produced by the choroid plexus of the lateral third and fourth ventricles at a rate of 0.35 mL/min. The CSF flows into the subarachnoid space and is absorbed by the arachnoid villi in the sagittal sinus. Normal CSF pressure is 5 to 15 cm H2O. Neurologic symptoms may occur when CSF pressure reaches more than 15 to 20 cm H2O.1 Three concomitant factors are needed for CSF leakage: an osseous defect, a meningeal disruption, and a pressure gradient.2

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