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7 results

  • Cerebrospinal fluid rhinorrhoea: does fibrin glue change the surgical outcome?

  • P B Ganesh, B M Basavarajaiah, B A Rudrappa, S K Kasaragod
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 7 / July 2020
    Published online by Cambridge University Press:
    16 July 2020, pp. 582-585
    Print publication:
    July 2020
  • Objective

    Cerebrospinal fluid rhinorrhoea takes place when there is a breakdown of the barriers separating the nasal cavity from the subarachnoid space. The aim of this study was to assess the surgical outcomes of endoscopic transnasal cerebrospinal fluid leak repair with and without fibrin glue.

    Method

    There were 43 patients with cerebrospinal fluid rhinorrhoea who underwent surgery for cerebrospinal fluid leak repair between 2014 and 2018. Patients were divided into group A, where fibrin glue was used, and group B, where fibrin glue was not used.

    Results

    It was found that 74.4 per cent of cases were due to spontaneous cerebrospinal fluid leak. The most common site of a leak was the cribriform plate (65 per cent). There was a success rate of 96.1 per cent (25 of 26) in group A and 83 per cent (15 of 17) in group B. There was no statistically significant difference between the results of the two groups (chi-square test: p = 0.31).

    Conclusion

    There was no statistically significant difference in the results of cerebrospinal fluid leak repair with and without fibrin glue.

  • Ecchordosis physaliphora: a cautionary tale

  • C Georgalas, D Terzakis, M Tsikna, Z Alatzidou, S de Santi, V Seccia, I Dallan
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 1 / January 2020
    Published online by Cambridge University Press:
    20 December 2019, pp. 46-51
    Print publication:
    January 2020
  • Background

    Ecchordosis physaliphora is a congenital, benign lesion originating from notochordal remnants along the craniospinal axis, most frequently located at the level of the clivus and sacrum. Sometimes ecchordosis physaliphora is difficult to recognise and treat, with a total of twenty-six cases described in the literature.

    Methods

    This study reports on three cases of previously undiagnosed ecchordosis physaliphora presenting with cerebrospinal fluid rhinorrhoea and meningitis.

    Conclusion

    Endoscopic transclival or transsphenoid surgery including three-layer (fat, fascia and nasoseptal flap) reconstruction was used in all cases with complete resolution of the symptoms.

  • Cerebrospinal fluid rhinorrhoea revealing an unusual ethmoido-sphenoidal foreign body

  • A Aubin, S Moriniere, P François, D Bakhos
  • Journal:
    The Journal of Laryngology & Otology / Volume 126 / Issue 9 / September 2012
    Published online by Cambridge University Press:
    12 July 2012, pp. 939-941
    Print publication:
    September 2012
  • Introduction:

    Foreign bodies in the transnasal ethmoido-sphenoidal sinus are uncommon. We present a case of unilateral rhinorrhoea caused by a foreign body which had been lodged in the ethmoido-sphenoidal sinus for 38 years.

    Case report:

    A 40-year-old woman presented with unilateral rhinorrhoea. Computed tomography showed a foreign body located in the right ethmoido-sphenoidal sinus, with a defect of the lamina papyracea and the ethmoid roof. The endonasal approach did not permit extraction of the foreign body. A combined approach allowed the extraction of a pen cap, and the defect of the ethmoid roof was rebuilt.

    Conclusion:

    Despite its limitations, the endonasal approach remains the treatment of first choice for osteo-meningeal defects, because of its minimal invasiveness and high success rate. However, in the presented case a combined approach was needed.

  • Cerebrospinal fluid rhinorrhoea after nasal packing for epistaxis: case report

  • O Edkins, C T Nyamarebvu, D Lubbe
  • Journal:
    The Journal of Laryngology & Otology / Volume 126 / Issue 4 / April 2012
    Published online by Cambridge University Press:
    24 February 2012, pp. 421-423
    Print publication:
    April 2012
  • Objective:

    We report a case of traumatic cerebrospinal fluid rhinorrhoea following nasal packing with a Rapid Rhino inflatable balloon pack, as treatment for epistaxis.

    Method:

    Case report and review of the literature regarding this complication.

    Results:

    A thorough literature search was performed using PubMed. To our best knowledge, there have been no previous reports of cerebrospinal fluid rhinorrhoea following nasal packing. In our case, cerebrospinal fluid leakage occurred due to fracture of the middle turbinate at its superior skull base insertion. The cerebrospinal fluid leak resolved spontaneously without the need for surgical intervention.

    Conclusion:

    This case report highlights not only the need for an appreciation of sinonasal anatomy and the potential risks associated with nasal packing, but also the need for adequate training in the use of commercially available nasal packs by medical practitioners attending patients with epistaxis.

  • Study on spontaneous cerebrospinal fluid rhinorrhoea: its aetiology and management

  • C J Dunn, A Alaani, A P Johnson
  • Journal:
    The Journal of Laryngology & Otology / Volume 119 / Issue 1 / January 2005
    Published online by Cambridge University Press:
    08 March 2006, pp. 12-15
    Print publication:
    January 2005

  • The aim of this study was to identify the common features in a study group of patients with spontaneous cerebrospinal fluid (CSF) rhinorrhoea, to develop a hypothesis to explain the cause of this condition and to investigate the outcome of surgical techniques adopted to repair the leak. In this retrospective study the authors have reviewed all the cases of spontaneous CSF leaks attending and receiving treatment from the otolaryngology department of Queen Elizabeth Hospital, Birmingham, from 1992 to 2002.

    Of 34 patients with CSF leaks, 15 were spontaneous in nature and formed the study group. Of these 15 patients, 14 were female; with ages ranging from 37 to 70 years and a median age of 50 years. All the female patients were overweight with a body mass index (BMI) >24.9 and, of these, nine were considered obese with a BMI >30. It was attempted to identify common factors in the study group and it was evident that female sex, obesity and age played a key role in this condition.

    The follow-up period ranged from two to 98 months. Thirteen patients were asymptomatic but two patients remained symptomatic, one of these despite repeated surgical intervention.

  • Spontaneous CSF rhinorrhoea from separate defects of the anterior and middle cranial fossa

  • U. Raghavan, S. Majumdar, N. S. Jones
  • Journal:
    The Journal of Laryngology & Otology / Volume 116 / Issue 7 / July 2002
    Published online by Cambridge University Press:
    08 March 2006, pp. 546-547
    Print publication:
    July 2002

  • Multiple congenital dehiscence of the skull base is rare and can give rise to spontaneous CSF rhinorrhoea. A search of the world literature revealed only five reports of CSF leak with more than one concomitant skull base defect. When treating a patient with spontaneous CSF rhinorrhoea the possibility of its originating from the middle ear and eustachian tube should be considered. An intrathecal injection of fluorescein is useful in establishing the site of a CSF leak especially when a computed tomography scan (CT) or magnetic resonance image (MRI) has not localized the site. We discuss a case of a 72-year-old lady presenting with CSF rhinorrhoea, who had an anterior skull base defect localized with the help of intrathecal fluorescein and repaired surgically. Subsequent to this she had a further episode of CSF rhinorrhoea that originated from a middle-ear meningocele that was then repaired.