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Abstract
Cerebrospinal fluid (CSF) rhinorrhea is classified into traumatic and non-traumatic types. Traumatic CSF rhinorrhea comprises the majority of cases, and major causes include head trauma, rhinologic procedures, and neurosurgery. Non-traumatic (spontaneous) CSF rhinorrhea with normal cerebrospinal pressure is a rare condition, occurring in only 4% of cases. We recently experienced a case of spontaneous CSF rhinorrhea complicated with bacterial meningitis. The defect site was identified in the left sphenoid sinus and was successfully repaired with a nasoseptal flap under an endoscopic approach. We present the etiology, classification, and treatment of this rare disease entity with a review of the literature.
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Fig. 1.
Axial ( A) and coronal ( B) sections of preoperative computed tomography and magnetic resonance imaging ( C). The arrows indicate fluid collection in the left sphenoid sinus.
Fig. 2.
Findings of metrizamide computed tomography cister-nography. Arrow indicates bony defect of posterolateral wall of the left sphenoid sinus.
Fig. 3.
Endoscopic findings and schematic illustration of pedicled nasoseptal flap. Cerebrospinal fluid leakage was identified at the posterolateral wall of the left sphenoid sinus ( arrow) ( A). Harvest of the nasoseptal flap ( B). Cerebrospinal fluid leakage site was cov-ered with nasoseptal flap ( C).
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