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Non-traumatic cerebrospinal rhinorrhea and chondrodystrophy.
Acta Oto-Laryngologica
|January 1, 1979
Summary
Two males with chondrodystrophy experienced non-traumatic cerebrospinal fluid leaks due to hydrocephalus. A ventriculocardiostomy and rhinosurgical approach successfully closed the fistula, highlighting the fronto-nasal route for skull base exposure.
Area of Science:
- Neurology
- Neurosurgery
- Otolaryngology
Background:
- Chondrodystrophy is a group of skeletal disorders affecting cartilage and bone growth.
- Hydrocephalus, an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles, can lead to increased intracranial pressure.
- Non-traumatic cerebrospinal rhinorrhea is a rare condition involving CSF leakage from the nose without a preceding injury.
Observation:
- Two adolescent males with chondrodystrophy presented with spontaneous cerebrospinal rhinorrhea.
- Both patients exhibited hydrocephalus as the underlying cause of CSF leakage.
- Elevated intracranial pressure was a significant clinical feature in both cases.
Findings:
- A ventriculocardiostomy was performed to reduce intracranial pressure.
- The cerebrospinal fluid fistula was successfully closed using a rhinosurgical extradural approach.
- The fronto-nasal approach provided optimal and minimally traumatic exposure of the frontal skull base.
Implications:
- This case series suggests that a combined neurosurgical and rhinosurgical approach can effectively manage non-traumatic cerebrospinal rhinorrhea in patients with hydrocephalus and chondrodystrophy.
- The fronto-nasal approach is recommended for its efficacy and reduced trauma in accessing the frontal skull base for fistula repair in such complex cases.
- Further research into the specific mechanisms linking chondrodystrophy, hydrocephalus, and spontaneous CSF leaks may elucidate preventative or therapeutic strategies.