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

Area of Science:

• Neurosurgery
• Otolaryngology
• Rhinology

Background:

• Cerebrospinal fluid (CSF) rhinorrhoea is the abnormal leakage of CSF from the cranial cavity into the nasal passages.
• Indications for surgical repair include spontaneous, recurrent, persistent, or meningitis-associated CSF leaks.
• Endonasal endoscopic repair is a minimally invasive approach for managing CSF rhinorrhoea.

Observation:

• A rare case of delayed-onset traumatic CSF rhinorrhoea with multiple dural defect sites is presented.
• The initial presentation involved a spontaneous leak nine years after the initial trauma.
• The patient underwent successful endonasal endoscopic repair for the multiple defects.

Findings:

• The endonasal endoscopic approach effectively repaired the complex CSF leak.
• The patient remained asymptomatic for nine years post-surgery, indicating long-term efficacy.
• A subsequent spontaneous CSF leak in the frontal recess was also successfully managed via the endonasal route.

Implications:

• This case underscores the efficacy of endonasal endoscopic surgery for complex and delayed-onset CSF rhinorrhoea.
• It highlights the possibility of late-onset leaks even after initial successful repair.
• The findings support the endonasal endoscopic approach as a viable, long-term solution for managing CSF leaks with multiple defects.