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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las f&#237;stulas traum&#225;ticas de LCR aparecen en un 511&#37; de pacientes con fractura demostrada de base de cr&#225;neo&#46; El riesgo potencial de las mismas es el desarrollo de meningitis postraum&#225;tica&#46; La prevenci&#243;n de la meningitis se basa en la reparaci&#243;n quir&#250;rgica de la f&#237;stula cuando las medidas conservadoras no lo consiguen&#46; Se han propuesto diversas t&#233;cnicas de cierre&#44; con una cifra de recidiva de f&#237;stula y&#47;o meningitis de hasta el 25&#37; seg&#250;n los autores&#46; Analizamos nuestros resultados&#44; en t&#233;rminos de cese de la rinorrea y desaparici&#243;n de nuevos episodios de meningitis&#44; en una serie consecutiva de 56 pacientes intervenidos en la CSUB entre 1987 y 1998 con la realizaci&#243;n de un abordaje bifrontal intradural con exploraci&#243;n de la totalidad de la fosa anterior y recubrimiento de &#233;sta con un colgajo pediculado de pericr&#225;neo&#46; Todos los pacientes fueron estudiados mediante TAC craneal con cortes axiales y coronales prescindiendo de forma deliberada de otras t&#233;cnicas de imagen para la localizaci&#243;n de la f&#237;stula&#46; Con un seguimiento de entre 1 y 11 a&#241;os &#40;media 5&#46;6 a&#241;os&#41; no se ha detectado ning&#250;n caso de recidiva de f&#237;stula ni nuevos episodios de meningitis&#46; La mortalidad operatoria fue nula y s&#243;lo dos pacientes presentaron anosmia tras la cirug&#237;a&#46; La exploraci&#243;n quir&#250;rgica bilateral de la fosa anterior y su tapizado completo con un colgajo pediculado permite un sellaje y separaci&#243;n definitivas entre la cavidad craneal y las cavidades nasosinusales&#46; El uso de abordajes unilaterales y el uso de tejidos no vascularizados debe ser evitado en el manejo de esta patolog&#237;a&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Between 5&#8211;11&#37; of patients harboring skull base fractures may present with cerebrospinal fluid &#40;CSF&#41; fistula&#46; Their risk is the development of posttraumatic meningits&#46; Surgical repair of the dural defect&#44; when conservative measures fail&#44; is mandatory in order to avoid new episodes of meningitis&#46; Several surgical procedures have been proposed with an overall failure rate around 25&#37;&#46; Between 1987&#8211;1998 we treated 56 patients with posttraumatic CSF fistula and&#47;or posttraumatic meningits with a bifrontal craniotomy&#44; intradural exploration and carpeting of the anterior fossa with a pediculated pericranial flap&#46; All patients underwent preoperative axial and coronal CT-scan and deliberately we did not use other imaging techniques to 10calize the fistula&#46; After a follow-up of 1&#8211;11 years &#40;mean 5&#46;6 y&#41; no recurrent episodes of meningitis or rhinorrhea have been detected&#46; There was not operative mortality and 2 patients developped anosmia after the surgical procedure&#46; A bilateral surgical exploration and complete covering of the anterior fossa floor with a pediculated pericranial flap allows a safe sealing as well as an effective isolation between anterior fossa and paranasal cavities&#46; Unilateral approaches as well as nonvascularized materials should be avoided in the management of these patients&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Acebes&#44; J&#46;J&#46;&#59; Cabiol&#44; J&#46;&#59; L&#243;pez-Obarrio&#44; L&#46;&#59; Serra&#44; J&#46;M&#46;&#59; Gabarr&#243;s&#44; A&#46;&#59; Isamat&#44; F&#46;&#58; Craniotom&#237;a bifrontal y colgajo pediculado de pericr&#225;neo en el tratamiento de las f&#237;stulas traum&#225;ticas de LCR&#46; Neurocirug&#237;a 1999&#59; 10&#58; 445&#8211;452&#46;</p>"
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                            4 => "L&#46; Wid&#233;n"
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                      "titulo" => "The galea frontalis myofascialis flap in anterior fossa CSF leaks"
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                      "titulo" => "CSF rhinorrhea&#58; detection and localization using overpressure cisternography with Tc-99<span class="elsevierStyleHsp" style=""></span>m-DTPA"
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* Servicios de Cirugía Plástica Ciutat Sanitaria i Universitaria de Bellvitge. Barcelona

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