[Apparently primary cerebrospinal rhinorrhea. Apropos of 4 cases]

While rhino-liquorrhea is a severe condition, its incidence is not exceptionally rare, and it raises problems, namely etiopathogenic, diagnostic and therapeutical ones, which call for the close collaboration of ENT doctors, neuroradiologists and neurosurgeons. 4 relatively recent cases are reported here, whereby the diversity of the problems encountered is made apparent. ENT specialists must be aware of those when faced with refractory aqueous rhinorrhea, often triggered by forward head motion, Valsalva's maneuver... Screening for rhinorrhea is readily achieved by biochemical tests, or simply using a Labstix-type diagnostic strip. Rhinoscopic examination should be accurate and carried out optically to check for any congenital malformation (meningocele). Most of the times, but not always, a thorough radio-neurological workup (isotopic analysis, CT-scan with contrast medium, MR imaging) will provide precise data regarding the infraction site and its possible cause, invariably warranting surgical management. Surgery should be case-adapted (CSF derivation, filling of the gap via the extra- or intracranial approach).