Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T06:59:11.675Z Has data issue: false hasContentIssue false

Idiopathic diffuse erosion of the skull base presenting as cerebrospinal fluid rhinorrhoea

Published online by Cambridge University Press:  29 June 2007

P. J. Conboy
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Queens Medical Centre, University Hospital, Nottingham, UK.
I. J. M. Johnson
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Queens Medical Centre, University Hospital, Nottingham, UK.
T. Jaspan
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Queens Medical Centre, University Hospital, Nottingham, UK.
N. S. Jones*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Queens Medical Centre, University Hospital, Nottingham, UK.
*
Address for correspondence: N. S. Jones, F.R.C.S., Department of Otorhinolaryngology – Head and Neck Surgery, Queens Medical Centre, University Hospital, NottinghamNG7 2UH.

Abstract

We present an unusual case of generalized erosion of the skull base. We have not found a similar case reported in the world literature. The presenting symptom was spontaneous cerebrospinal fluid (CSF) rhinorrhoea which arose from a bony defect associated with herniation of the right temporal lobe into the sphenoid sinus. We discuss the management of such a case including imaging of the skull base and the endoscopic repair of the bony defect.

Type
Radiology in Focus
Copyright
Copyright © JLO (1984) Limited 1998

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

Abrahams, J. J., Eklund, J. A. (1995) Diagnostic radiology of the cranial base. Clinics in Plastic Surgery 22 (3): 373405.CrossRefGoogle ScholarPubMed
Dodson, E. E., Gross, C. W., Swerdloff, J. L., Gustafson, L. M. (1994) Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea and skull base defects: a review of twenty-nine cases. Otolaryngology - Head and Neck Surgery 111: 600605.Google ScholarPubMed
Dohlman, G. (1948) Spontaneous cerebrospinal rhinorrhoea. Ada Otolaryngologica 67 (Supp): 2023.CrossRefGoogle ScholarPubMed
Frankel, D. G., Lewin, J. S., Cohen, B. (1997) Massive osteolysis of the skull base. Pediatric Radiology 27: 265267.CrossRefGoogle ScholarPubMed
Hamlin, J. A., Hasso, A. N. (1994) Magnetic resonance imaging of the skull base. Topics in Magnetic Resonance Imaging 6(3): 183201.CrossRefGoogle ScholarPubMed
Hughes, R. G. M., Jones, N. S., Robertson, I. J. A. (1997) The endoscopic treatment of cerebrospinal fluid rhinorrhoea: the Nottingham experience. Journal of Laryngology and Otology 111: 125128.CrossRefGoogle ScholarPubMed
Klastersky, J., Sadeghi, M., Brihaye, J. (1976) Antimicrobial prophylaxis in patients with rhinorrhea or otorrhea: a double-blind study. Surgical Neurology 6: 111114.Google ScholarPubMed
Laine, F. J., Nadel, L., Braun, I. F. (1990) CT and MR imaging of the central skull base. Radiographics 10(5): 797821.CrossRefGoogle Scholar
Lanza, D. C., O'Brien, D. A., Kennedy, D. W. (1996) Endoscopic repair of cerebrospinal fistulae and encephaloceles. Laryngoscope 106: 11191125.CrossRefGoogle ScholarPubMed
Lustrin, E. S., Robertson, R. L., Tilak, S. (1994) Normal anatomy of the skull base. Neuroimaging Clinics of North America 4 (3): 465478.Google ScholarPubMed
MacGee, E. E., Cauthen, J. C., Brackett, C. E. (1970) Meningitis following acute traumatic cerebrospinal fluid fistula. Journal of Neurosurgery 33: 312316.CrossRefGoogle ScholarPubMed
Madeline, L. E., Elster, A. D. (1995) Postnatal development of the central skull base: Normal variants. Radiology 196(3): 757763.CrossRefGoogle ScholarPubMed
McCoy, G. (1963) Cerebrospinal rhinorrhoea: a comprehensive review and a definition of the responsibility of the rhinologist in diagnosis and treatment. Laryngoscope 73: 11251157.CrossRefGoogle Scholar
Pappas, D. G. Jr., Hammerschlag, P. E., Hammerschlag, M. (1993) Cerebrospinal fluid rhinorrhea and recurrent meningitis. Clinical Infectious Diseases 17: 364368.CrossRefGoogle ScholarPubMed
Schick, B., Draf, W., Kahle, G., Weber, R., Wallenfang, T. (1997) Occult malformations of the skull base. Archives of Otolaryngology-Head and Neck Surgery 123(1): 7780.CrossRefGoogle ScholarPubMed
Tolley, N. S., Lloyd, G. A. S., Williams, H. O. L. (1991) Radiological study of primary spontaneous CSF rhinorrhoea. Journal of Laryngology and Otology 105: 274277.CrossRefGoogle ScholarPubMed
Wigand, M. E. (1981) Transnasal ethmoidectomy under endoscopical control. Rhinology 19: 715.Google ScholarPubMed