A conservative surgical strategy for spontaneous cerebrospinal fluid leakage: a rare case report

Abstract

A 59-year-old male with no history of trauma or surgery presented with clear rhinorrhea occurring when he bent his head forward. A CT scan revealed localized fluid accumulation and a lateral wall defect involving the left sphenoid sinus. Using the transpterygoid approach, we widened the anterior wall of the sphenoid sinus inferolaterally to expose the lesion as much as possible. Reconstruction involved placing an interposition graft between the dura and the bony defect using the underlay technique, followed by free mucosal grafting. Histopathological examination revealed neuroglial cells, confirming the diagnosis of spontaneous cerebrospinal fluid rhinorrhea due to a meningoencephalocele.