有茎中鼻甲介粘膜弁による鼻性髄液漏閉鎖を要した髄膜瘤例

抄録

Cerebrospinal fluid (CSF) rhinorrhea is a potentially critical condition, in which the sinonasal mucosa is connected with the intracranial subarachnoid space through a fissure in the skull base and the CSF mixes with the nasal discharge. It could be traumatic or nontraumatic. Nontraumatic CSF rhinorrhea could be caused by spontaneous liquorrhea, meningocele (meningoencephalocele), skull base neoplasm, etc. In cases of spontaneous CSF rhinorrhea, spontaneous wound healing may not be expected. Herein, we report a patient who was diagnosed as a case of CSF rhinorrhea after she presented with the signs of meningitis. The patient was an obese woman in her 50 s, who presented with headache, fever and left rhinorrhea. Transnasal endoscopic examination revealed a meningocele at the olfactory cleft. The defect was repaired successfully using a mucosal pedicle flap obtained from the middle nasal turbinate. Thereafter, we examine the anatomy of the cribriform plate and consider some useful endoscopic techniques.