2018 Volume 111 Issue 1 Pages 29-33
Cerebrospinal fluid (CSF) rhinorrhea is a disorder of the skull base in which the CSF flows into the nasal sinuses. Such traffic between the skull and nasal cavities can cause intracranial infections. Cerebrospinal rhinorrhea has been broadly classified as traumatic and atraumatic CSF rhinorrhea. Traumatic CSF rhinorrhea is usually caused by head injuries or nasal sinus surgery, and atraumatic CSF rhinorrhea can be idiopathic or congenital, or result from infiltration tumors of the paranasal sinuses and skull base tumors. Traumatic CSF rhinorrhea has been reported to occur in about 2% of cases of head trauma. There are few reports of atraumatic CSF rhinorrhea. Especially, that of idiopatic causation is said to be rare. Diagnosis is based on the symptoms, imaging findings, and detection of CSF-specific protein or glucose in the nasal discharge. Conservative treatment is the approach of first choice for the management of traumatic CSF rhinorrhea, and surgical treatment is the treatment of first choice for atraumatic CSF rhinorrhea. The surgical approach could be intracranial or extracranial. With the advances in endoscopic sinus surgery techniques, transnasal endoscopic repair has become mainstream. We report an example of treatment of a case of spontaneous CSF rhinorrhea by endoscopic sinus surgery.
