Rarely the collection of a nasal swab or the placement of nasal packing material can result in a cerebrospinal fluid (CSF) leak.
Risk factors for an iatrogenic CSF leak:
(1) history of prior skull base defects including encephalocele
(2) history of sinus or skull base surgery
(3) conditions associated with skull base erosion
(4) use of a rigid swab (versus flexible swab) or instrument
(5) excessive force applied
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