Etiology and treatment strategy of spontaneous cerebrospinal fluid rhinorrhea

Abstract

Cerebrospinal fluid （CSF） rhinorrhea is the result of an abnormal communication between sinonasal tract and the subarachnoid space through skull base defect. The etiology of CSF rhinorrhea can be traumatic, iatrogenic, tumor induced and spontaneous. Spontaneous CSF rhinorrhea （SCSFR） occurs in the absence of trauma, surgery, or other inducing events. SCSFR is rarely encountered in daily clinical practice, thus misdiagnosis is common when the clinical symptoms are atypical. SCSFR does not typically self-resolve and requires surgical repair. Timely and effective closure of defects is critical to avoid potentially serious consequences including brain abscess and meningitis. Clinical research indicated an underestimation of SCSFR in the past. Nowadays, with the improvement of diagnostic techniques and clinical awareness, the detection rate of SCSFR has increased. This study conducted a systematic review about the etiology and treatment strategy of SCSFR.