Dear Jack,
I am a physician, and I would like to answer your question as follows:
The incidence of brain complications following sinus surgery is very
low. However, leakage of the fluid surrounding the brain, know as
cerebrospinal fluid or CSF, is a remote possibility. If the surgeon
spots a leak or opening during surgery, he or she may be able to close
it immediately. In this situation, the only repercussion may be a
slightly longer hospital stay and/or extended recuperation period, but
if the leak is not discovered during surgery, or if there was some
direct damage to the brain, it could lead to serious complications. If
you experience a clear watery discharge running out of your nose when
you lean forward after surgery, bring it to the attention of your
physician immediately.
A CSF leak creates a potential pathway for the spread of infection and
in some cases could result in meningitis or intracranial (brain)
infection. Please note that these are worst-case scenarios that are
very unlikely to occur.
http://www.sinusinfocenter.com/sinus_treatment_endoscopic.html
Here is a link to an image of how CSF leak occurs:
http://www.american-rhinologic.org/images/picture1.gif
So to answer your question, If i operated and bacam aware
intraoperatively that there was a CSF leak, then it would be a simple
matter of closing the leak during the operation itself.
However it is possible that the leak was not picked up intraop, and
hence the complication of meningitis that has occurred after 15 months.
The diagnostic modality of choice would proabbaly be a contrast CT
(with metrizamide) called MCTC (Metrizamide enhanced Cisternography or
an MRV (MRI for veins) and nuclear studies (for details see this )
Do let me know if you need more information, please remember
to 'accept' the reply if you find it useful; a positive rating & a bonus at
your discretion would be appreciated,
Regards
Dr. Gupta