{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:17:39Z","timestamp":1776917859880,"version":"3.51.2"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[1983,8,1]],"date-time":"1983-08-01T00:00:00Z","timestamp":428544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[1983,8]]},"abstract":"<jats:p>CSF rhinorrhea can have many causes: traumatic, neoplastic, and iatrogenic origins are common. Most traumatic rhinorrhea ceases after a trial of conservative management. While obvious erosion or traumatic destruction of vital structures may be the underlying cause, other pathophysiologic mechanisms may be working in the formation of CSF rhinorrhea, which may require the combined skills of the otolaryngologist and the neurosurgeon. Leakage of CSF is seen in \u201chigh\u2010pressure rhinorrhea,\u201d a pathophysiologic state wherein the underlying problem is poor CSF resorption. The result is increased intracranial pressure and eventual rhinorrhea or otorrhea. Areas of CSF leakage correspond to sites of congenital weakness in the cribriform plate region, the parasellar region, or the temporal bone. Weak areas in old base\u2010of\u2010skull fracture sites may leak with increased intracranial pressure. The initial management should stress correction of the deranged pathophysiology, namely shunting. Surgical repair is secondary to controlling the abnormal CSF dynamics.<\/jats:p>","DOI":"10.1177\/019459988309100410","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T06:58:43Z","timestamp":1448434723000},"page":"399-403","source":"Crossref","is-referenced-by-count":14,"title":["Cerebrospinal Fluid Dynamics and Rhinorrhea: The Role of Shunting in Repair"],"prefix":"10.1002","volume":"91","author":[{"given":"Arnold","family":"Komisar","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Neurosurgery Albert Einstein College of Medicine Montefiore Hospital and Medical Center Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Weitz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Neurosurgery Albert Einstein College of Medicine Montefiore Hospital and Medical Center Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Ruben","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Neurosurgery Albert Einstein College of Medicine Montefiore Hospital and Medical Center Bronx New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1983,8]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/91.4.707"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/93.4.679"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-197701000-00019"},{"key":"e_1_2_1_5_1","first-page":"1208","article-title":"Spontaneous cerebrospinal rhinorrhea","volume":"1","author":"Livni S","year":"1938","journal-title":"Br Med J"},{"key":"e_1_2_1_6_1","volume-title":"The cerebrospinal fluid, its spontaneous escape from the nose","author":"Thompson SC","year":"1899"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1926.02200210030003"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-194012000-00007"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-194510000-00002"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-192308000-00011"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1937.00650010065007"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.31.3.214"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1969.30.4.0406"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1978.49.3.0393"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459988309100410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/019459988309100410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:46:10Z","timestamp":1760957170000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/019459988309100410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1983,8]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1983,8]]}},"alternative-id":["10.1177\/019459988309100410"],"URL":"https:\/\/doi.org\/10.1177\/019459988309100410","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[1983,8]]}}}