[Repair of recurrent osteo-meningeal lesions at the base of the skull]. / Réparation des brèches ostéo-méningées récidivantes de la base du crâne

Treatment of cerebro-spinal fluid rhinorrhea from traumatic or tumoral origin, by simple dural patching, is not always sufficient because of the possible necrosis of the patch, mainly in case of severe osteo-meningeal defects. After having pointed out the frequency of such recurrences (5 to 30%, according to the data of literature), the authors report 6 personal cases successfully reoperated in order to repair the osteo-dural lesions with autogenous aponeurosis and bone grafts. 4 were after traumatism and 2 after removal of a tumor, in fronto-ethmoido-sphenoidal base of the skull. The authors suggest to combine bone reconstruction by autograft to the dural repair, even in case of primary fistula, when there is a severe traumatic or tumoral bone defect, or when we are dealing with a spontaneous rhinorrhea which is known to be generally due to local C.S.F. hyperpressure.