[Some problems of nontraumatic nasal rhinorrhea]

The paper outlines some issues of nontraumatic nasal liquorrhea. The authors state that in the vast majority of cases, liquorrhea occurs along the passage of olfactory filaments through the perforated lamina. Their morphological studies provide indirect evidence for this statement. Encephalomeningocele through the perforated lamina of the ethmoid bone or Turkish saddle is much more infrequent cause of liquorrhea. The authors have developed 2 methods of surgical treatment: 1) endonasal closure of a fistula and 2) its intracranial closure. With mode 1, the nasal mucosa in the upper nasal passage and roof is destroyed and muscle tamponade is made. This method was used to operate on 66 patients. Liquorrhea recovered in 13 patients. It is less traumatic and less expensive and less effective. With method 2, trepanation is made in the frontal region, the dura mater is dissected, the olfactory bulb is destroyed and the site of the perforated lamina is tamponed with a muscle tissue piece. A total of 23 patients were operated on, a good result was achieved in 22 patients of them. Subsequently liquorrhea did not restore in any case. The method is more traumatic, but more effective. With method 3, if liquorrhea occurs through the Turkish saddle, the procedure to close a fistula corresponds to endonasal plasty, only the site of fistular destruction is the sphenoid sinus. The tip of an aspirator is inserted through the aperture of the sinus, its mucosa is destroyed, thereafter it is tamponed with a muscle flap. Three patients were operated on. Liquorrhea ceased.