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Radiological study of primary spontaneous CSF rhinorrhoea

Published online by Cambridge University Press:  29 June 2007

N. S. Tolley*
Affiliation:
London
G. A. S. Lloyd
Affiliation:
London
H. O. L. Williams
Affiliation:
London
*
Mr N. S. Tolley, M.D., F.R.C.S., Flat 11, Belle Vue Court, Belle Vue Gardens, Brighton BN2 2AN.

Abstract

A radiological study of skull base anatomy was performed in patients presenting with primary spontaneous CSF rhinorrhoea. Radiology correctly identified the fistula site in 90 per cent of cases. Contrast CT imaging was found to be the most suitable technique for identifying the presence and site of CSF fistulae. However, pre-contrast bony dehiscences were identified in all patients leaking from the cribriform plate region. More significantly, all of these patients showed deviation of their crista galli, a radiological sign hitherto unreported. These findings support the theory that congenital bony dehiscence is the aetiological basis for this condition. The importance of radiology in the management of this condition is emphasized.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1991

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References

Ahmadi, J., Weiss, M. H., Segall, H. D., Schultz, D. H., Zee, C.-S., Giannotta, S. L. (1985) Evaluation of cerebrospinal fluid rhinorrhoea by metrizamide computed tomographic cisternography. Neurosurgery, 16: 5460.Google ScholarPubMed
Anderson, W. M., Schwartz, G. A., Gommon, G. D. (1961) Chronic spontaneous cerebrospinal fluid rhinorrhoea. Archives of Internal Medicine, 107: 723731.CrossRefGoogle Scholar
Brisman, R., Hughes, J. E. O., Mount, L. A. (1969) Cerebrospinal fluid rhinorrhoea and the empty sella. Journal of Neurosurgery, 31: 538543.CrossRefGoogle ScholarPubMed
Calcaterra, T. C. (1980) Extracranial surgical repair of cerebrospinal rhinorrhoea. Annals of Otology, Rhinology and Laryngology, 89: 108116.CrossRefGoogle Scholar
Di Chiro, G., Reames, P. H. (1964) Isotopic localization of cranionasal cerebrospinal fluid leaks. Journal of Nuclear Medicine, 5: 376 (Abstract).Google Scholar
Drayer, B. P., Wilkins, R. H., Boehnke, M., Horton, J. A., Rosenbaum, A. E. (1977) Cerebrospinal fluid rhinorrhoea demonstrated by metrizamide CT cisternography. American Journal of Radiology, 129: 149151.Google ScholarPubMed
Hammer, B., Lackner, W. (1980) Iopamidol, a new ionic hydrosoluble contrast medium for neuroradiology. Neuroradiology, 19: 119121.CrossRefGoogle ScholarPubMed
Lang, J. (1989) Clinical anatomy of the nose, nasal cavity and paranasal sinuses. Thieme, New York.Google Scholar
Lantz, E. J., Forbes, G. S., Brown, M. L., Laws, E. R. (1980) Radiology of cerebrospinal fluid rhinorrhoea. Americ an Journal of Neuroradiology, 1: 391398.Google Scholar
Levy, J. M., Christensen, F. K., Nykamp, P. W. (1978) Detection of a cerebrospinal fluid fistula by computed tomography. American Journal of Roentgenology, 131: 344345.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
Manelfe, C., Guirand, B., Tremoulet, M. (1977) Diagnosis of CSF rhinorrhoea by computerized cisternography using metrizamide. Lancet, 2: 1073.CrossRefGoogle ScholarPubMed
Montgomery, W. W. (1973) Cerebrospinal fluid rhinorrhoea. Otolaryngologic Clinics of North America, 6: 757771.CrossRefGoogle Scholar
Morley, T. P., Wortzman, G. (1965) The importance of the lateral extensions of the sphenoidal sinus in post-traumatic cerebrospinal rhinorrhoea and meningitis. Clinical and radiological aspects. Neurosurgery, 22: 326332.CrossRefGoogle ScholarPubMed
Ohnishi, T. (1981) Bony defects and dehiscences of the roof of ethmoid cells. Rhinology, 19: 195202.Google ScholarPubMed
Ommaya, A. K. (1976) Spinal fluid fistulae. Clinical Neurosurgery, 23: 363392.CrossRefGoogle ScholarPubMed
Peele, J. C. (1957) Unusual anatomical variations of the sphenoid sinus. Laryngoscope, 67: 208237.CrossRefGoogle Scholar
Salar, G., Carteri, A., Zampieri, P. (1978) The diagnosis of CSF fistulas with rhinorrhoea by isotope cisternography. Neuroradiology, 15: 185187.CrossRefGoogle ScholarPubMed
Thomson, St Clair. (1899) The cerebrospinal fluid. Its spontaneous escape from the nose with observations of its composition and function in human subjects. Cassell & Co. Ltd, London p. 10.Google Scholar
Troland, C. E. (1960) The surgical treatment of spontaneous cerebrospinal rhinorrhoea. Archives of Otolaryngology, 72: 254255.CrossRefGoogle Scholar