scholarly journals Recurrent meningitis caused by idiopathic cerebrospinal fluid rhinorrhoea from the sphenoid sinus

2018 ◽  
pp. bcr-2017-222296
Author(s):  
Motoki Hirabayashi ◽  
Kazuhiro Omura ◽  
Nobuyoshi Otori ◽  
Yasuhiro Tanaka
1990 ◽  
Vol 104 (4) ◽  
pp. 328-330 ◽  
Author(s):  
H. B. Whittet ◽  
S. Barker ◽  
P. Anslow ◽  
S. Leighton

AbstractHeterotopic brain tissue is a rare cause of symptoms in neonates in whom it may present with respiratory obstruction. In infants it may produce unilateral nasal obstruction due to a nasal ‘polyp’ or cerebrospinal fluid rhinorrhoea with an associated risk of meningitis. It is exceedingly rare in adults but may nevertheless be a cause of significant morbidity as this case demonstrates.


1998 ◽  
Vol 112 (8) ◽  
pp. 779-781 ◽  
Author(s):  
J. M. Reynolds ◽  
A. Tomkinson ◽  
R. G. Grigg ◽  
C. F. Perry

AbstractMeningo-encephalocoeles of the skull base may present as spontaneous cerebrospinal fluid rhinorrhoea or acute meningitis. Previous approaches to midline skull base lesions have been either intracranial, via a craniotomy, or by transfacial or endoscopic extracranial approaches. This paper presents an alternative approach to lateral sphenoid sinus encephalocoeles through a Le Fort I osteotomy approach.


2019 ◽  
Vol 18 (2) ◽  
pp. 322-328 ◽  
Author(s):  
Tan Yee Wen ◽  
Balwant Singh Gendeh ◽  
Rohana Ali O’Connell Husain ◽  
Salina Husain ◽  
Kamalan Jeevaratnam

Objective: The purpose of this study is to review the correlation of spontaneous cerebrospinal fluid rhinorrhoea (CSFR) and Body Mass Index (BMI) and describe the demographics, the surgical techniques and outcomes. Materials and methods: We performed a retrospective review of clinical data of twenty patients diagnosed with spontaneous CSFR and treated at the Malaysian National University Medical Centre from 1997 to 2015. Result and Discussion: A total of 20 patients were selected in this research (19 females,1male). The mean age was 45.5 years with nineteen females and one male patient. The mean BMI was 33.1kg/m2.Majority of patients with spontaneous leaks are females in their forties. The bath plug technique, onlay of middle turbinate grafts, nasoseptal flaps and mucoperiosteal grafts techniques were used and three patients reported recurrences. Conclusion: Spontaneous CSFR is more common in women in their 40s with BMI>25. The most common sites of leaks are the cribriform plate followed by the sphenoid sinus. Spontaneous CSFR cases are strongly related with increased BMI. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.322-328


1980 ◽  
Vol 73 (4) ◽  
pp. 244-254 ◽  
Author(s):  
I E Cole ◽  
Malcolm Keene

Three cases of CSF rhinorrhoea due to pituitary tumours are reported and the literature reviewed. The treatment of choice appears to be trans-sphenoidal exploration of the pituitary fossa with insertion of a free muscle graft followed by radiotherapy. The probability of the tumour being a prolactin-secreting adenoma is discussed.


2010 ◽  
Vol 124 (12) ◽  
pp. 1294-1297 ◽  
Author(s):  
P Thulasi Das ◽  
D Balasubramanian

AbstractObjective:To present our experience in managing cerebrospinal fluid rhinorrhoea using the cartilage inlay (underlay) technique to repair skull base defects larger than 4 mm.Study design:Retrospective study involving patients presenting with cerebrospinal fluid rhinorrhoea between 1994 and 2008.Setting:Patients were treated in a tertiary referral centre for nose and sinus diseases. Patients' medical records were reviewed and analysed.Results:A total of 62 patients were operated upon using a cartilage inlay technique to repair bony skull base defects ranging in size from 4 to 20 mm (widest diameter). Of these 62 patients, 16 constituted revisions of earlier procedures undertaken elsewhere. The success rate of the technique was 100 per cent. Patient follow up ranged from six months to 16 years, with a median follow up of 15 months. Three patients had minor post-operative sinus infections; no serious complications were encountered.Conclusion:Extradural cartilage inlay appears to be an effective technique in the management of cerebrospinal fluid rhinorrhoea, especially for large defects and revision procedures. To our knowledge, the described patients represent the largest reported series of cerebrospinal fluid rhinorrhoea cases managed using the cartilage inlay technique. We believe that the crucial factors in our high success rate for cerebrospinal fluid fistula repair are: precise identification of the bony defect; meticulous preparation of the graft bed; careful elevation of the dura; judicious use of just enough graft tissue; and adequate graft support.


2017 ◽  
Vol 37 (4) ◽  
pp. 303-307
Author(s):  
C. Zhang ◽  
X. Ding ◽  
Y. Lu ◽  
L. Hu ◽  
G. Hu

Lo scopo del presente studio è stato quello di chiarire i fattori di rischio della rinoliquorrea a seguito di un approccio transfenoidale e di discuterne la prevenzione e il trattamento. Abbiamo revisionato retrospettivamente 474 casi consecutivi di adenoma ipofisario trattati con 485 procedure chirurgiche per via transfenoidale da Gennaio 2008 a Dicembre 2011 nel nostro dipartimento. Abbiamo analizzato l’incidenza di fuoriuscita di liquor cefalorachidiano intraoperatoriamente e nel postoperatorio, e la riuscita di varie strategie di riparazione. Abbiamo riscontrato fuoriuscita di liquor intraoperatoriamente in 85 casi (17.9%) e postoperatoriamente in 13 casi (2.7%). Sette dei 13 pazienti con rinoliquorrea postoperatoria non avevano mostrato fuoriuscita di liquor intraoperatoriamente; tre di questi pazienti avevano adenomi secernenti ADH. Dei rimanenti 6 pazienti con fuoriuscita di liquor sia intra che postoperatoria, 2 erano stati trattati per prolattinoma gigante e invasivo e 2 erano già stati sottoposti in passato a chirurgia trasnfenoidale. In 8 pazienti la fuoriuscita è stata risolta mediante puntura lombare, drenaggio lombare, riposo in posizione semi-reclinata o altri trattamenti conservativi. Due casi sono stati trattati mediante schiuma di gelatina e colla di fibrina utilizzando un approccio transfenoidale e due con grasso autologo e ricostruzione del pavimento della sella utilizzando un approccio transnasale endoscopico. Dopo essere stato sottoposto a due tentativi di riparazione per via transasale, un paziente è stato trattato con successo mediante un ulteriore drenaggio subaracnoideo. In conclusone le procedure che fanno uso di schiuma di gelatina, colla di fibrina e impianti di grasso autologo sono efficaci ai fini del trattamento della rinoliquorrea postoperatoria in pazienti sottoposti a chirurgia transfenoidale. Quando viene rilevata una perdita di liquido cefalorachidiano in corso di chirurgia transfenoidale, un’appropriata ricostruzione del pavimento della sella e un follow up a lungo termine sono necessari.


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