Rhinorrhea associated with intracranial cholesteatomas and an "empty sella."

Area of Science:

• Neurology
• Otolaryngology
• Radiology

Background:

• Intracranial cholesteatomas are rare, with bilateral symmetrical cases unreported.
• Empty sella syndrome involves herniation into the sella due to a deficient diaphragma sella.
• Cerebrospinal rhinorrhea, particularly non-traumatic, is an uncommon condition with varied etiologies.

Observation:

• A single patient presented with the simultaneous occurrence of bilateral primary intracranial cholesteatomas, empty sella syndrome, and cerebrospinal rhinorrhea.
• This combination of disorders has not been previously documented in medical literature.
• The otolaryngologist may be the first clinician to identify cerebrospinal rhinorrhea.

Findings:

• The report discusses the etiologic, clinical, and management factors of this unique case.
• It emphasizes the rarity of bilateral symmetrical intracranial cholesteatomas.
• The case underscores the importance of considering multiple rare conditions presenting concurrently.

Implications:

• This case provides valuable insights for diagnosing and managing complex neurological and otolaryngological presentations.
• It may prompt further investigation into potential links between these seemingly disparate conditions.
• Enhanced awareness among clinicians can improve early diagnosis and treatment of such rare combined pathologies.