Efficacy of adjunctive lumbar drain insertion with skull base repair in the management of CSF rhinorrhea: a meta-analysis study

Abstract Background Cerebrospinal fluid (CSF) rhinorrhea represents an uncommon yet clinically important disorder in which CSF escapes from the cranial cavity into the nasal and paranasal sinus passages. This condition arises from a variety of underlying factors, broadly categorized as traumatic (whether owing to accidental injury or medical intervention) and non-traumatic, often described as spontaneous. Each category demonstrates unique epidemiologic patterns and clinical presentations. Aim of the work To estimate the value of lumbar drain (LD) insertion in conjunction with surgical skull base repair in patients exhibiting CSF rhinorrhea. Patients and methods The meta-analysis comprised seven eligible studies, involving a total of 306 patients. Three studies, including 211 patients, had valid data for comparing the utilization of a lumbar drain (LD group, n = 64 patients) without employing a lumbar drain (non-LD group, n = 147 patients). Results All seven investigations were involved in the one-arm meta-analysis for estimating the incidence of CSF leak associated with lumbar drain use. Conclusion There appears to be no clear benefit from the insertion of a lumbar drain during skull base repair for the treatment of CSF rhinorrhea. High-quality prospective investigations with strict inclusion standards are needed to shed light on the value of lumbar drain in select subgroups of patients at elevated risk of recurrence.