Meningoencephalocele in Frontal Sinus with Cerebrospinal Fluid Rhinorrhea

Abstract

A 48-year-old man was referred to us complaining of a copious clear watery discharge from his left nostril, that had started 8 weeks earlier. Tomographic studies revealed a mass in the left frontal sinus. A radioisotope was introduced into the subarachnoid space by lumbar puncture, and 3 hours later the radioactivity of pledgets in the left nasal cavity was significantly greater than in the right nasal cavity. Cerebrospinal fluid rhinorrhea through the left frontal sinus was therefore diagnosed. An extranasal approach was selected for repairing the cerebrospinal fluid leakage. The polypoid tissue in the left frontal sinus was removed. There were two bony defects in the posterior wall of this sinus. These defects were successfully closed by fascia lata with the use of a fibrin sealant, and continuous spinal drainage was done pre- and post- operatively. The postoperative course was uneventful. Histological diagnosis of the tissue removed from the frontal sinus was menigoencephalocele.