Vol.103 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 103 No. 3 March 2010
A Case of Cerebral Spinal Fluid (CSF) Rhinorrhea Associated with
Multiple-locus Meningoencephalocele
Ayako Furuya, Tomohiro Ono, Tomoaki Mori, Aya Kaburagi,
Kiyoaki Kamakazu, Toshikazu Shimane, Hajime Terao and Takeyuki Sanbe
(Showa University Fujigaoka Hospital)
Harumi Suzaki
(Showa University School of Medicine)
Many cases of traumatic cerebral spinal fluid (CSF) rhinorrheas arise from head injury or surgery. Cases of nontraumatic CSF rhinorrhea arise rarely due to tumors or inherent bone defects. We report a case of CSF rhinorrhea associated with meningoencephalocele at two bone defect loci requiring surgery.
A 65-year-old man experienced watery rhinorrhea of the right nasal cavity in March 1997, followed a year later by meningitis yielding the diagnosis of CSF rhinorrhea. Computed tomography (CT) showed two bone defects and the associated meningoencephalocele in the right ethmoidal cell and left sphenoidal sinus. Initial skull base reconstruction surgery was conducted only for the right side where the symptom occurred. Ten years later, recurrent meningitis necessitated the left side skull base reconstruction surgery for a large infected defect for which could not obtain endoscopic sinus surgery closure. Combined transcranial surgery eventually attained sufficient closure.
Key words :cerebral spinal fluid rhinorrhea, meningoencephalocele, bone defect