Lymphangioma of the skull base bones leading to cerebrospinal fluid rhinorrhea

2008 ◽  
Vol 2 (4) ◽  
pp. 273-276 ◽  
Author(s):  
Eiji Ito ◽  
Kiyoshi Saito ◽  
Tetsuya Nagatani ◽  
Masaaki Teranishi ◽  
Yuzuru Kamei ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Skull Base ◽  
Histopathological Examination ◽  
Bone Destruction ◽  
Lytic Lesion ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Csf Leakage ◽  
The Right

Lymphangioma localized to the bones of the skull base is rare. The authors report herein the case of a 5-year-old boy who presented with lymphangioma of the bone, localized to the skull base and leading to cerebrospinal fluid (CSF) rhinorrhea with meningitis. Neuroimaging demonstrated lytic destruction with a cyst in the right middle skull base. The patient was successfully treated with resection of the tumor and prevention of CSF leakage. Histopathological examination revealed a lymphangioma. An enlarging lymphangioma can lead to bone destruction. A differential diagnosis of a lytic lesion for a cyst at the skull base is important for proper case management.

The Use of Methylene Blue Staining Test in Determining the CSF Leaks Location of the Anterior Skull Base

2018 ◽  
Vol 69 (6) ◽  
pp. 1376-1377
Author(s):  
Razvan Hainarosie ◽  
Teodora Ghindea ◽  
Irina Gabriela Ionita ◽  
Mura Hainarosie ◽  
Cristian Dragos Stefanescu ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Cerebrospinal Fluid ◽  
Intrathecal Injection ◽  
Diagnostic Procedures ◽  
Blue Staining ◽  
Csf Leak ◽  
Glucose Content ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Csf Leakage

Cerebrospinal fluid rhinorrhea represents drainage of cerebrospinal fluid into the nasal cavity. The first steps in diagnosing CSF rhinorrhea are a thorough history and physical examination of the patient. Other diagnostic procedures are the double ring sign, glucose content of the nasal fluid, Beta-trace protein test or beta 2-transferrin. To establish the exact location of the defect imagistic examinations are necessary. However, the gold standard CSF leakage diagnostic method is an intrathecal injection of fluorescein with the endoscopic identification of the defect. In this paper we analyze a staining test, using Methylene Blue solution, to identify the CSF leak�s location.

scholarly journals Minimally Invasive Repair of a Delayed Recurrent Traumatic Cerebrospinal Fluid Rhinorrhea: A Case Report of Dislocation of the Bony and Dural Defects

2020 ◽  
Author(s):  
Xiaofei Liu ◽  
Ping Chen ◽  
Bing Wang
Keyword(s):  
Cerebrospinal Fluid ◽  
Minimally Invasive ◽  
Bony Defect ◽  
Dural Defect ◽  
Csf Rhinorrhea ◽  
Invasive Approach ◽  
Fascial Flap ◽  
Anterior Cranial Base ◽  
Csf Leakage ◽  
The Right

Abstract Background：Dural and bony defects mostly occur in the same position in the cerebrospinal fluid（CSF）rhinorrhea of anterior cranial base fractures,and a few cases of delayed CSF leakage after repair are also reported.Case presentation：We report a case in which a pedicled temporoparietal fascial flap was used to repair the comminuted fracture of the anterior skull base with CSF leakage. Delayed CSF leakage occurred 45 days after the operation.A minimally invasive approach through an eyebrow incision was performed for reoperation,it was found that the bony defect was located in the right frontal sinus and the dural defect was located in the right ethmoid plate. Conclusions:This case suggests that delayed traumatic CSF rhinorrhea after reconstructive surgery is more complex than usual,and appropriate approach should be adopted to repair the dural and bony defects , the transeyebrow approach is a good choice.

Untreated Non-Functioning Pituitary Adenoma Causing Spontaneous Cerebrospinal Fluid Rhinorrhea: A Case Report

2020 ◽  
Vol 103 (9) ◽  
pp. 960-963
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Case Reports ◽  
Medical Attention ◽  
Nasal Discharge ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Presenting Symptoms ◽  
Csf Leakage

Cerebrospinal fluid (CSF) leakage is common with traumatic brain injury or after transsphenoidal surgery (TSS). In contrast, spontaneous rhinorrhea caused by pituitary adenoma (PA) without prior treatment is rather unusual. Moreover, cases of non-functioning PA (NFPA) who seek medical attention without visual or hormonal symptoms but with watery nasal discharge, mistaken for rhinitis, and misled to delayed diagnosis, are extremely rare. The authors presented a case of spontaneous CSF rhinorrhea, confirmed by clinical, laboratory, and radiographic studies, caused by NFPA. Endoscopic TSS came across a typical PA, and subsequently, the sellar defect was successfully repaired. Pathological diagnosis of NFPA was established. The patient had an uncomplicated postoperative course and complete resolution of her presenting symptoms. A short review of prior case reports is also provided. Keywords: Spontaneous cerebrospinal fluid rhinorrhea, Pituitary adenoma, Non-functioning, Endoscopic transsphenoidal surgery

Prevention of Cerebrospinal Fluid Rhinorrhea After Transsphenoidal Surgery by Collagen Fleece Coated With Fibrin Sealant Without Autologous Tissue Graft or Postoperative Lumbar Drainage

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons130-ons137 ◽  
Author(s):  
Jin Mo Cho ◽  
Jung Yong Ahn ◽  
Jong Hee Chang ◽  
Sun Ho Kim
Keyword(s):  
Cerebrospinal Fluid ◽  
Fibrin Sealant ◽  
Transsphenoidal Surgery ◽  
Csf Leak ◽  
Autologous Tissue ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Tissue Graft ◽  
Csf Leakage ◽  
Sellar Floor

Abstract BACKGROUND: Autologous tissue grafting and postoperative lumbar cerebrospinal fluid (CSF) drainage (PLD) have been used to prevent CSF rhinorrhea after transsphenoidal surgery. OBJECTIVE: To describe the technical details and efficacy of our techniques of using collagen fleece coated with fibrin sealant (TachoComb, Nycomed, Linz, Austria) instead of an autologous tissue graft and refraining from the use of PLD. METHODS: We retrospectively reviewed 307 consecutive patients who underwent a transsphenoidal surgery for pituitary adenoma from November 2005 to February 2008. Among them, 90 cases of intraoperative CSF leaks were repaired with TachoComb without an autologous tissue graft or PLD. The repair procedures were tailored according to CSF leakage type, and we used only Bioglue (Cryolife Inc, Atlanta, Georgia) for sellar floor reconstruction. RESULTS: The overall rate of CSF rhinorrhea was 2.2% (2 of 90 cases). The 2 cases of CSF rhinorrhea resulted from large arachnoid defects, and there were no adverse effects from TachoComb such as transmission of viral disease or infection. CONCLUSION: Our technique is an alternative method to the traditional autologous tissue graft technique. PLD is not an essential procedure for the prevention of CSF rhinorrhea if the intraoperative CSF leak is completely sealed off during the transsphenoidal surgery. However, in cases of large arachnoid defects, aggressive repair of the arachnoid defect and sellar floor reconstruction with bone or bony substitutes should be considered in conjunction with our methods.

Diagnosis and treatment of cerebrospinal fluid rhinorrhea following accidental traumatic anterior skull base fractures

2012 ◽  
Vol 32 (6) ◽  
pp. E3 ◽  
Author(s):  
Mateo Ziu ◽  
Jennifer Gentry Savage ◽  
David F. Jimenez
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Head Injuries ◽  
Anterior Skull Base ◽  
Surgical Approaches ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Diagnosis And Management ◽  
Increased Risk ◽  
Technical Advances

Cerebrospinal fluid rhinorrhea is a serious and potentially fatal condition because of an increased risk of meningitis and brain abscess. Approximately 80% of all cases occur in patients with head injuries and craniofacial fractures. Despite technical advances in the diagnosis and management of CSF rhinorrhea caused by craniofacial injury through the introduction of MRI and endoscopic extracranial surgical approaches, difficulties remain. The authors review here the pathophysiology, diagnosis, and management of CSF rhinorrhea relevant exclusively to traumatic anterior skull base injuries and attempt to identify areas in which further work is needed.

scholarly journals A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kohei Matsuo ◽  
Satoshi Tanaka ◽  
Masayuki Sakata ◽  
Hiroki Takeda ◽  
Akihiro Nagata ◽  
...  
Keyword(s):  
Skull Base ◽  
Bone Erosion ◽  
Histopathological Examination ◽  
Bone Destruction ◽  
Mycobacterial Infection ◽  
Asian Woman ◽  
Nerve Paralysis ◽  
Malignant Lesions ◽  
The Right ◽  
Bony Erosion

Primary nasopharyngeal mycobacteriosis is a rare disease. We present a case in which skull base bone erosion appeared and was alleviated during the course of the treatment. Bone complications occur in osteoarticular mycobacteriosis, but their occurrence in primary nasopharyngeal mycobacteriosis has not been reported. A 77-year-old immunocompromised Asian woman presented with a right occipitotemporal headache. An ulcerative mass covered with a thick yellowish discharge was found in the roof and posterior walls of the right nasopharynx. Because histopathological examination indicated the presence of mycobacterial infection, we began using antituberculosis medication for the treatment because of the possibility of primary nasopharyngeal tuberculosis. However, this was followed by glossopharyngeal and vagus nerve paralysis. Computed tomography (CT) showed a diffuse enhancing mucosal irregularity in the nasopharynx with bony erosion of the external skull base. Deep tissue biopsy was repeated to differentiate it from malignant lesions, and drainage of pus from the right nasopharynx was confirmed. Subsequently, the headache, neurological findings, and the yellowish discharge disappeared, and the bony erosion of the external skull base was alleviated. Surgical intervention should also be considered for drug-resistant mycobacteriosis. We concluded that mycobacteriosis should also be considered apart from carcinoma even if CT shows a diffuse enhancing mucosal irregularity with bone destruction in the nasopharynx.

scholarly journals An Unusual Case of Delayed Recurrent Traumatic Cerebrospinal Fluid Rhinorrhea

2020 ◽  
Author(s):  
Xiaofei Liu ◽  
Ping Chen ◽  
Bing Wang
Keyword(s):  
Cerebrospinal Fluid ◽  
Good Choice ◽  
Bony Defect ◽  
Dural Defect ◽  
Csf Rhinorrhea ◽  
Invasive Approach ◽  
Fascial Flap ◽  
Anterior Cranial Base ◽  
Csf Leakage ◽  
The Right

Abstract Background: Dural and bony defects mostly occur in the same position in the cerebrospinal fluid (CSF) rhinorrhea of anterior cranial base fractures, and a few cases of delayed CSF leakage after repair are also reported.Case presentation: We report a case in which a pedicled temporoparietal fascial flap was used to repair the comminuted fracture of the anterior skull base with CSF leakage. Delayed CSF leakage occurred 45 days after the operation. A minimally invasive approach through an eyebrow incision was performed for reoperation, it was found that the bony defect was located in the right frontal sinus and the dural defect was located in the right ethmoid plate. Conclusions: This case suggests that delayed traumatic CSF rhinorrhea after reconstructive surgery is more complex than usual, and appropriate approach should be adopted to repair the dural and bony defects, the transeyebrow approach is a good choice.

Evaluation of Endoscopic Transnasal versus Non-endoscopic Routes as Surgical Treatment of Cerebrospinal Fluid Rhinorrhea

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ashraf Mohamed Farrag ◽  
Talaat Ali Hassan El Samnni ◽  
Tamer Abdul Wahab El Sabri Abou El Ezz ◽  
Mohamed Naguib Mohamed El Sayed
Keyword(s):  
Cerebrospinal Fluid ◽  
Meta Analysis ◽  
Cerebrospinal Fluid Leak ◽  
Csf Leak ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Csf Leakage ◽  
Fluid Leak ◽  
The Brain ◽  
Better Than

Abstract Introduction Cerebrospinal fluid (CSF) leak happens when there is an abnormal connection between the brain cavity inside and environment outside. It is important to establish a good barrier between the brain tissue and the nose to prevent cerebrospinal fluid leak and protect the brain from exposure to infection. which can be done either by endoscopic or non-endoscopic surgical repair. Patients and methods The aim of this work is to evaluate the effectiveness of endoscopic and non-endoscopic repair of CSF leakage in patients suffering from CSF rhinorrhea. The search retrieved 1693 unique records. We then retained 89 potentially eligible records for full-texts screening. Finally, 11 studies (Total No. of patients = 355) were included in the present systematic review and meta-analysis. Results CSF rhinorrhea resolved in endoscopic surgery group giving a success rate of 88.8%to 100%. recurrence rate is 2% to 12.2% and postoperative complications occurred in 5% to 16.7%. Conclusion The endoscopic approach is highly effective, better than non-endoscopic route and is associated with low morbidity for the management of CSF rhinorrhea .

scholarly journals Postoperative Cerebrospinal Fluid Leak after Septoplasty: A Potential Complication of Occult Anterior Skull Base Encephalocele

2013 ◽  
Vol 4 (1) ◽  
pp. ar.2013.4.0043 ◽  
Author(s):  
Resha S. Soni ◽  
Osamah J. Choudhry ◽  
James K. Liu ◽  
Jean Anderson Eloy
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Cerebrospinal Fluid Leak ◽  
Anterior Skull Base ◽  
Intracranial Abscess ◽  
Ethmoid Bone ◽  
Csf Rhinorrhea ◽  
Csf Leakage ◽  
Skull Base Defect ◽  
Fluid Leak

Postoperative cerebrospinal fluid (CSF) rhinorrhea after septoplasty is a known entity resulting from errors in surgical technique and improper handling of the perpendicular plate of the ethmoid bone. When these occur, urgent management is necessary to prevent deleterious sequelae such as meningitis, intracranial abscess, and pneumocephalus. Encephaloceles are rare occurrences characterized by herniation of intracranial contents through a skull base defect that can predispose patients to CSF rhinorrhea. In this report, we present a case of CSF rhinorrhea occurring 2 weeks after septoplasty likely from manipulation of an occult anterior skull base encephalocele. To our knowledge, no previous similar case has been reported in the literature. Otolaryngologists should be aware of the possibility of occult encephaloceles while performing septoplasties because minimal manipulation of these entities may potentially result in postoperative CSF leakage.

scholarly journals Delayed Presentation of Traumatic Cerebrospinal Fluid Rhinorrhea: Case Report and Literature Review

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0132 ◽  
Author(s):  
Richard A. Guyer ◽  
Justin H. Turner
Keyword(s):  
Cerebrospinal Fluid ◽  
Head Injury ◽  
Skull Base ◽  
Late Onset ◽  
Closed Head Injury ◽  
Csf Leak ◽  
Delayed Presentation ◽  
Traumatic Head Injury ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea

Cerebrospinal fluid (CSF) leak is one of several complications that can occur after traumatic skull base injury. Although most patients present soon after the injury occurs, some can present years later, with resulting morbidity and the need for additional procedures. We present a case of a patient with a sphenoid sinus CSF leak who presented 12 years after a closed head injury that included a sphenoethmoid skull base fracture. We also reviewed the literature on this topic, with a discussion of previous reports of CSF leaks that occurred months, years, or decades after trauma. A late onset CSF leak appears to be a rare but important complication of traumatic skull base injury. This case highlights the need for clinicians to remain vigilant to the possibility of delayed CSF rhinorrhea, even years after traumatic head injury.

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