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Bilateral, spontaneous cerebrospinal fluid rhinorrhoea: endoscopic, uninasal, trans-septal approach for simultaneous closure

Published online by Cambridge University Press:  03 August 2011

M Kurien ,
G A Mathew ,
S L Abraham  and
A Irodi
M Kurien*
Affiliation:
Department of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, India
G A Mathew
Affiliation:
Department of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, India
S L Abraham
Affiliation:
Department of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, India
A Irodi
Affiliation:
Department of Radiodiagnosis, Christian Medical College, Vellore, India
*
Address for correspondence: Dr Mary Kurien, Professor, Dept. of ENT, Head and Neck Surgery, Speech and Hearing, Christian Medical College, Vellore, Tamil Nadu, 632004, India E-mail: ent2@cmcvellore.ac.in
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Abstract

Background:

Bilateral, spontaneous cerebrospinal fluid rhinorrhoea is extremely rare, with only one previous case report (this patient developed contralateral cerebrospinal fluid leakage four years after successful endoscopic repair). We present the first English-language report of simultaneous, bilateral, spontaneous cerebrospinal fluid rhinorrhoea.

Objective:

To recommend a simple alternative endoscopic technique for simultaneous closure of bilateral, spontaneous cerebrospinal fluid rhinorrhoea.

Case report:

A 47-year-old woman presented with recent onset of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, a recent history suggestive of meningitis, and a past history of pneumococcal meningitis. Bony defects on both sides of the cribriform plate were closed endoscopically in the same anaesthetic session, via a uninasal, trans-septal approach, enabling both leakage sites to be sealed simultaneously.

Conclusion:

In cases of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, uninasal, trans-septal endoscopic repair is a simple and effective technique for simultaneous closure of cerebrospinal fluid leakage.

Keywords

Cerebrospinal Fluid Rhinorrhoea, SpontaneousNasal CavityMinimally Invasive Surgical Procedure
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 11 , November 2011 , pp. 1185 - 1188
Copyright
Copyright © JLO (1984) Limited 2011

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