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Spontaneous CSF Rhinorrhea Our Experience.

D S Deenadayal1, D Vidyasagar1, M Naveen Kumar1

  • 1Department of Ent, Head and Neck Surgery, Yashoda Hospital, Secunderabad, 500003 Andhra Pradesh India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|January 16, 2014
PubMed
Summary
This summary is machine-generated.

Spontaneous cerebrospinal fluid (CSF) rhinorrhea, often seen in obese females, can be effectively treated with transnasal endoscopic repair. This single endoscopic procedure demonstrated a high success rate and safety margin in the study.

Keywords:
Cerebrospinal fluidEndoscopic sinus surgeryRhinorrhea

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Area of Science:

  • Neurosurgery
  • Otolaryngology

Background:

  • Spontaneous cerebrospinal fluid (CSF) rhinorrhea is a rare condition.
  • It predominantly affects middle-aged, obese females.

Purpose of the Study:

  • To identify factors contributing to spontaneous CSF rhinorrhea.
  • To evaluate the outcomes of transnasal endoscopic repair for this condition.

Main Methods:

  • Retrospective case series of 7 patients diagnosed with spontaneous CSF rhinorrhea between January 2006 and May 2010.
  • High-resolution computed tomography (HRCT) of paranasal sinuses (1 mm cuts) was the primary imaging modality, supplemented by CT cisternography, CSF analysis, and MRI.
  • Transnasal endoscopic repair using fascia lata autograft was performed on 5 patients.

Main Results:

  • All 7 patients were diagnosed with spontaneous CSF rhinorrhea.
  • 5 patients were obese, middle-aged females.
  • Successful repair was achieved in all patients with a single endoscopic procedure; no revisions were required.
  • The anterior cribriform plate was the most common site of leakage.

Conclusions:

  • Spontaneous CSF rhinorrhea is most common in middle-aged, obese females, often with leaks at the anterior cribriform plate.
  • Transnasal endoscopic repair is a highly successful and safe procedure for CSF rhinorrhea, especially when the skull base defect is not extensive.
  • HRCT paranasal sinus imaging is an effective diagnostic tool for spontaneous CSF rhinorrhea.