Skip to main content

Advertisement

SpringerLink
Log in

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

  • Clinical Report
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Cerebrospinal fluid (CSF) rhinorrhoea is the leakage of CSF through the communication between the subarachnoid space and the nasal cavity. Surgical repair is indicated in all cases of spontaneous leaks, recurrent leaks, leaks that do not stop after conservative management and cases with history of meningitis. We present a rare case of spontaneous (delayed onset post traumatic) CSF rhinorrhoea with multiple defect sites, which was treated with an endonasal endoscopic repair. The patient was asymptomatic for 9 years after surgery, and then presented with a spontaneous left frontal recess CSF leak, which was closed using endonasal approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Milford CA (1997) In: Mackay IS, Bull TR (eds) Scott Brown’s otolaryngology. Rhinology 4: 14/1–4/12/12

  2. Colquhoun IR (1993) CT cisternography in the investigation of cerebrospinal fluid rhinorrhea. Clin Radiol 47:403–408

    Article  CAS  PubMed  Google Scholar 

  3. Eljamel MS, Fay PM (1990) Acute traumatic CSF fistula: the risk of intracranial infection. Br J Neurosurg 4:381–385

    Article  CAS  PubMed  Google Scholar 

  4. Ramsden JD, Rogan C, Bates G (2000) Bilateral cerebrospinal fluid rhinorrhoea. J Laryngol Otol 114:137–138

    CAS  PubMed  Google Scholar 

  5. Shetty P, Shroff M, Kirtane M, Karmarkar S (1997) CSF otorhinorrhea in patients with defects through the lamina cribrosa of the internal auditory canal. AJNR 18:478–481

    CAS  PubMed  Google Scholar 

  6. Schlosser RJ, Blger WE (2004) Nasal cerebrospinal fluid leaks; critical review and surgical consideration. Laryngoscope 114:255–265

    Article  PubMed  Google Scholar 

  7. Skedros DG, Cass SP, Hirsch BE, Kelly RH (1993) Sources of error in use of β-2 transferrin analysis for diagnosing perilymphatic and cerebral spinal fluid leaks. Otolaryngol Head Neck Surg 109:861–864

    Article  CAS  PubMed  Google Scholar 

  8. Llyod MN, Kimber PM, Burrows EH (1994) Post traumatic CSF rhinorrhoea: modern high definition computed tomography is all that is required for the effective demonstration of the site of leakage. Clin Radiol 49:100–103

    Article  Google Scholar 

  9. Manelfe C, Guirand B, Tremoulet M (1997) Diagnosis of CSF rhinorrhea by computerized cisternography using metrizamide. Lancet 2:1073

    Google Scholar 

  10. Mahaley MS Jr, Odom GL (1996) Complication following intrathecal injection of fluorescein. J Neurosurg 25(3):298–299

    Article  Google Scholar 

  11. Wallace JD, Weintriaub MI, Mattson RH, Rosnagle R (1972) Status epilepticus as a complications of intrathecal fluorescein. J Neurosurg 36:659–660

    Article  CAS  PubMed  Google Scholar 

  12. Moseley JI, Carton CA, Stern WE (1978) Spectrum of complications in the use of intathecal injection of flourescein. J Neurosurg 48(5):765–767

    Article  CAS  PubMed  Google Scholar 

  13. Roberto E, Guimaraes S et al (2002) Localization of skull based cerebrospinal fluid leaks by using intrathecal fluorescein in a hypodense solution during the surgery. Rev Braz Otorrinolaringol 68(6):788–792

    Google Scholar 

  14. Lund VJ, Savy L, Llyod G et al (2000) Optimum imaging and diagnosis of cerebrospinal fluid rhinorrhea. J Laryngol Otol 114:988–992

    CAS  PubMed  Google Scholar 

  15. Lund VJ (2002) Endoscopic management of cerebrospinal fluid leaks. Am J Rhinol 16:17–23

    PubMed  Google Scholar 

  16. McConachie NS, Joseph BV, Eljamel MS, Stafford Johnson BD (1995) Magnetic resonance cisternography of CSF otorhinorrhea. Int J Neuroradiol 1:177–181

    Google Scholar 

  17. Scholosser RJ, Bolger WE (2002) Traumatic cerebrospinal fluid rhinorrhoea. Otolaryngol Head Neck Surg 13:302–308

    Google Scholar 

  18. Wormald P, Mc Donogh M (1997) Bath-plug technique for the endoscopic management of cerebrospinal fluid leaks. J Laryngol Otol 3:1042–1046

    Google Scholar 

  19. Casiano RR, Jassir D (1999) Endoscopic cerebrospinal fluid rhinorrhoea repair: is a lumbar drain necessary ? Otolaryngol Head Neck Surg 121:745–750

    Article  CAS  PubMed  Google Scholar 

  20. Briggs RJS, Wormald PJ (2004) Endoscopic transnasal intradural repair of anterior skull base cerebrospinal fluid fistulae. J Clin Neurosci 11:597–599

    Article  CAS  PubMed  Google Scholar 

  21. Hegazy HM, Carrau RL, Snyderman CH, Kassam A, Zweig J (2000) Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea: a meta analysis. Laryngoscope 110:1166–1172

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study has not been funded by any agency or sponsor. It was conducted without any financial interest.

Author information

Authors and Affiliations

  1. Bombay Hospital and Medical Research Centre, Mumbai, India

    Nishit Shah & C.E. Deopujari

  2. Mumbai Port Trust Hospital, Flat No. 4, Charak, Mumbai Port Trust Hospital Campus, Wadala (E), Mumbai, Maharashtra, 400037, India

    Sunita Chhapola Shukla

Authors
  1. Nishit Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C.E. Deopujari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sunita Chhapola Shukla
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sunita Chhapola Shukla.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest. This material has never been published and is not currently under evaluation in any other peer reviewed publication.

Ethical Approval

This case report does not contain any studies with human participants or animals performed by any of the authors. All procedures performed involving human participant were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the patient included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shah, N., Deopujari, C. & Chhapola Shukla, S. Spontaneous Recurrent CSF Rhinorrhoea: A Rare Case and Review of Literature. Indian J Otolaryngol Head Neck Surg 69, 420–424 (2017). https://doi.org/10.1007/s12070-016-1024-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-016-1024-y

Keywords

Search

Navigation