Spontaneous CSF Rhinorrhea Our Experience

Abstract

To analyse the possible factors contributing to spontaneous cerebrospinal fluid (CSF) rhinorrhea and to assess the outcome of Transnasal endoscopic repair at our centre. Retrospective case series of patients with spontaneous CSF rhinorrhea at our institution from Jan 2006 to May 2010. 7 patients were diagnosed with spontaneous CSF rhinorrhea. 5 of the 7 patients were obese, middle aged females managed with Transnasal endoscopic repair with fascia lata auto graft. Successful repair of CSF rhinorrhea was achieved in all the patients with a single endoscopic procedure; no patient required a revision procedure. Spontaneous CSF rhinorrhea is a rare condition seen mostly in middle aged obese females with the anterior part of the cribriform plate being the most common site of leak. HRCT paranasal sinus (1mm cuts) was an effective modality of investigation in our study with ancillary investigations been CT Cisternography, CSF analysis and MRI for inactive leaks. In the absence of a large breech of the skull base, endoscopic repair of CSF rhinorrhea carries a high success rate with a high safety margin and very low morbidity rate.