Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T08:43:14.771Z Has data issue: false hasContentIssue false
  • English
  • Français

Bilateral, spontaneous cerebrospinal fluid rhinorrhoea: endoscopic, uninasal, trans-septal approach for simultaneous closure

Published online by Cambridge University Press:  03 August 2011

M Kurien ,
G A Mathew ,
S L Abraham  and
A Irodi
M Kurien*
Affiliation:
Department of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, India
G A Mathew
Affiliation:
Department of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, India
S L Abraham
Affiliation:
Department of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, India
A Irodi
Affiliation:
Department of Radiodiagnosis, Christian Medical College, Vellore, India
*
Address for correspondence: Dr Mary Kurien, Professor, Dept. of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, Tamil Nadu, 632004, India E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Bilateral, spontaneous cerebrospinal fluid rhinorrhoea is extremely rare, with only one previous case report (this patient developed contralateral cerebrospinal fluid leakage four years after successful endoscopic repair). We present the first English-language report of simultaneous, bilateral, spontaneous cerebrospinal fluid rhinorrhoea.

Objective:

To recommend a simple alternative endoscopic technique for simultaneous closure of bilateral, spontaneous cerebrospinal fluid rhinorrhoea.

Case report:

A 47-year-old woman presented with recent onset of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, a recent history suggestive of meningitis, and a past history of pneumococcal meningitis. Bony defects on both sides of the cribriform plate were closed endoscopically in the same anaesthetic session, via a uninasal, trans-septal approach, enabling both leakage sites to be sealed simultaneously.

Conclusion:

In cases of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, uninasal, trans-septal endoscopic repair is a simple and effective technique for simultaneous closure of cerebrospinal fluid leakage.

Keywords

Cerebrospinal Fluid Rhinorrhoea, SpontaneousNasal CavityMinimally Invasive Surgical Procedure
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 11 , November 2011 , pp. 1185 - 1188
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Park, J-I, Strelzow, W, Friedman, WH. Current management of cerebrospinal fluid rhinorrhoea. Laryngoscope 1983;93:1294–300CrossRefGoogle Scholar
2Ye, H, Zuo, J, Zhao, H, Liu, S, An, H, Liu, Y. Endonasal endoscopic repair of cerebrospinal fluid rhinorrhea in a series of 69 patients. Br J Neurosurg 2010;24:244–8CrossRefGoogle Scholar
3Presutti, L, Mattioli, F, Villari, D, Marchioni, D, Alicandri-Ciufelli, M. Transnasal endoscopic treatment of cerebrospinal fluid leak: 17 years' experience. Acta Otorhinolaryngol Ital 2009;29:191–6 [in English]Google ScholarPubMed
4Banks, CA, Palmer, JN, Chiu, AG, O'Malley, BW Jr, Woodworth, BA, Kennedy, DW. Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years. Otolaryngol Head Neck Surg 2009;140(6):826–33. Epub 2009 Feb 28.CrossRefGoogle ScholarPubMed
5Eljamel, MS, Foy, PM. Non-traumatic CSF fistulae: clinical history and management. Br J Neurosurg 1991;5:275–9CrossRefGoogle ScholarPubMed
6Wigand, ME. Transnasal ethmoidectomy under endoscopic control. Rhinology 1981;19:7–15Google Scholar
7Ramsden, JD, Corbridge, R, Bates, G. Bilateral cerebrospinal fluid rhinorrhoea. J Laryngol Otol 2000;114:137–8CrossRefGoogle ScholarPubMed
8Bernal-Sprekelsen, M, Bleda-Vazquez, C, Carrau, RL. Ascending meningitis secondary to traumatic cerebrospinal fluid leaks. Am J Rhinol 2000;14:257–9CrossRefGoogle ScholarPubMed
9Lund, VJ, Savy, L, Lloyd, G, Howard, D. Optimum imaging and diagnosis of cerebrospinal fluid rhinorrhoea. J Laryngol Otol 2000;114:988–92CrossRefGoogle ScholarPubMed
10Keerl, R, Weber, RK, Draf, W, Wienke, A, Schaefer, SD. Use of sodium fluorescein solution for detection of cerebrospinal fluid fistula: an analysis of 420 administrations and reported complications in Europe and the United States. Laryngoscope 2004;114:266–72CrossRefGoogle ScholarPubMed
11Seth, R, Rajasekaran, K, Benninger, MS, Batra, PS. The utility of intrathecal fluorescein in cerebrospinal fluid leak repair. Otolaryngol Head Neck Surg 2010;143:626–32CrossRefGoogle ScholarPubMed
12Stankiewicz, JA. Cerebrospinal fluid fistula and endoscopic sinus surgery. Laryngoscope 1991;101:250–6CrossRefGoogle ScholarPubMed
13Kelly, TF, Stankiewicz, JA, Chow, JM, Origitano, TC, Shea, J. Endoscopic closure of postsurgical anterior cranial fossa cerebrospinal fluid leaks. Neurosurgery 1996;106:1080–3Google Scholar