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A traumatic skull base fracture can breach the dura, leading to a communication, or fistula, from the intracranial cavity to the external environment. This leads to a risk of cerebrospinal fluid (CSF) leak in 10%–30% of patients, highest in fractures of the anterior cranial fossa.1 CSF can subsequently leak from the nose (rhinorrhoea) or ear (otorrhoea). Many CSF leaks will seal spontaneously within 1–2 weeks with conservative management, but if CSF leakage is prolonged, then operative repair of the fistula is needed (see Chapter 18 for details on CSF leak diagnosis and management).
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