{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:59:40Z","timestamp":1781261980564,"version":"3.54.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the incidence of cerebrospinal fluid (CSF) leaks after craniofacial cleft repair and to describe outcomes of conservative and surgical management approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Fatemeh Hospital, a tertiary referral center for craniofacial and neurosurgical procedures in Tehran, Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>A total of 121 patients who underwent primary or secondary craniofacial cleft repair between June 2019 and March 2024. Patients with a history of craniovertebral junction surgery, Chiari malformation, or ventriculoperitoneal shunting were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Patients with postoperative CSF leaks were managed with either lumbar drainage or surgical re-exploration. Intraoperative autologous fat grafts were used prophylactically in select patients without visible dural defects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Incidence of postoperative CSF leaks, occurrence of meningitis in leak cases, and resolution of leaks following conservative versus surgical treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CSF leaks occurred in 18 patients (14.8%), of whom 9 (50%) developed meningitis. Leak rates by Tessier classification were class 0 (19.6%), class 1 (12.1%), class 2 (11.1%), and class 3 (0%). There was no statistically significant association between cleft type and CSF leak incidence (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.478). Lumbar drainage resolved CSF leakage in 7 patients (38.9%), while 15 patients (83.3%) ultimately required surgical re-exploration. One leak (9%) occurred among the 11 patients who received prophylactic fat grafts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSF leaks were observed in approximately 15% of craniofacial cleft repairs and were frequently associated with meningitis. Surgical intervention was often required, highlighting the need for careful intraoperative dural management and early leak detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251369589","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T14:48:36Z","timestamp":1756133316000},"page":"2195-2202","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Management Outcomes of Cerebrospinal Fluid Leaks Following Craniofacial Cleft Repair: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3534-3305","authenticated-orcid":false,"given":"Sayedali","family":"Ahmadi","sequence":"first","affiliation":[{"name":"Iran University of Medical Sciences"},{"name":"Milad General 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