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Case Reports
. 2017 Sep;69(3):420-424.
doi: 10.1007/s12070-016-1024-y. Epub 2016 Oct 6.

Spontaneous Recurrent CSF Rhinorrhoea: A Rare Case and Review of Literature

Nishit Shah  1 , C E Deopujari  1 , Sunita Chhapola Shukla  2
Affiliations
Case Reports

Spontaneous Recurrent CSF Rhinorrhoea: A Rare Case and Review of Literature

Nishit Shah et al. Indian J Otolaryngol Head Neck Surg. 2017 Sep.

Abstract

Cerebrospinal fluid (CSF) rhinorrhoea is the leakage of CSF through the communication between the subarachnoid space and the nasal cavity. Surgical repair is indicated in all cases of spontaneous leaks, recurrent leaks, leaks that do not stop after conservative management and cases with history of meningitis. We present a rare case of spontaneous (delayed onset post traumatic) CSF rhinorrhoea with multiple defect sites, which was treated with an endonasal endoscopic repair. The patient was asymptomatic for 9 years after surgery, and then presented with a spontaneous left frontal recess CSF leak, which was closed using endonasal approach.

Keywords: CT cisternography; Endonasal endoscopic repair; High pressure CSF leaks; Meningitis; Multiple defect CSF leak; Recurrent cerebrospinal fluid rhinorrhoea; β-2-Transferrin.

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Conflict of interest statement

Conflict of interest

All authors declare that they have no conflict of interest. This material has never been published and is not currently under evaluation in any other peer reviewed publication.

Ethical Approval

This case report does not contain any studies with human participants or animals performed by any of the authors. All procedures performed involving human participant were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the patient included in the study.

Figures

Fig. 1
Fig. 1
Coronal CT scan with cisternography showing defect in right cribriform plate
Fig. 2
Fig. 2
Coronal CT scan with cisternography showing defect in left anterior fovea (red arrow)
Fig. 3
Fig. 3
Coronal CT scan with cisternography showing defect in infero-lateral wall of right sphenoid sinus
Fig. 4
Fig. 4
Operative photo showing encephalocele with CSF leak in infero-lateral wall of right sphenoid sinus, seen by 45° endoscope
Fig. 5
Fig. 5
Operative photo showing encephalocele with CSF leak in right cribriform plate, seen by 45 endoscope
Fig. 6
Fig. 6
Operative photo showing encephalocele in left anterior fovea, seen by 45 endoscope
Fig. 7
Fig. 7
Operative photo showing left anterior fovea defect closed with septal cartilage
See this image and copyright information in PMC

References

    1. Milford CA (1997) In: Mackay IS, Bull TR (eds) Scott Brown’s otolaryngology. Rhinology 4: 14/1–4/12/12
    1. Colquhoun IR. CT cisternography in the investigation of cerebrospinal fluid rhinorrhea. Clin Radiol. 1993;47:403–408. doi: 10.1016/S0009-9260(05)81061-X. - DOI - PubMed
    1. Eljamel MS, Fay PM. Acute traumatic CSF fistula: the risk of intracranial infection. Br J Neurosurg. 1990;4:381–385. doi: 10.3109/02688699008992759. - DOI - PubMed
    1. Ramsden JD, Rogan C, Bates G. Bilateral cerebrospinal fluid rhinorrhoea. J Laryngol Otol. 2000;114:137–138. - PubMed
    1. Shetty P, Shroff M, Kirtane M, Karmarkar S. CSF otorhinorrhea in patients with defects through the lamina cribrosa of the internal auditory canal. AJNR. 1997;18:478–481. - PMC - PubMed

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