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Cerebrospinal Fluid Leak Following Nasal Packing for Epistaxis

Federico Sireci1,2, Vincenzo Immordino1, Francesco Galletti2

  • 1Ear Nose and Throat Section, ARNAS Fatebenefratelli Hospital, Palermo.

The Journal of Craniofacial Surgery
|July 2, 2019
PubMed

Insights

Cerebrospinal fluid rhinorrhea and pneumocephalus can occur after Merocel nasal packing for epistaxis. Proper positioning by specialists is crucial to prevent serious complications like infection.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Medical Device Safety

Background:

  • Anterior epistaxis is frequently managed with Merocel nasal packing.
  • Merocel tampons are widely used for controlling nasal bleeding.

Observation:

  • A 63-year-old male experienced cerebrospinal fluid (CSF) rhinorrhea and pneumocephalus post-Merocel tampon insertion for epistaxis.
  • The patient subsequently developed fever and headache, indicating potential infection.

Findings:

  • Improper positioning of nasal Merocel packing can lead to severe complications.
  • Cerebrospinal fluid leak and intracranial air are risks associated with nasal packing.

Implications:

  • Highlights the critical need for specialized personnel in nasal packing insertion.
  • Emphasizes the importance of prompt diagnosis and management of CSF leaks and associated infections.
  • Underscores the necessity for standardized protocols in using nasal packing devices.

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