Vol. 5, Issue 12 (2019)
Study of trans-Nasal endoscopic repair of cerebrospinal fluid rhinorrhea
Author(s): Dr. Vandana Sharma, Dr. Rakesh Kumar Singh
Abstract: CSF rhinorrhoea is the condition in which CSF leaks through nasal cavity due to dural fistula. Common causes are nontraumatic, traumatic, and iatrogenic. Nontraumatic CSF rhinorrhea may be associated with normal CSF pressure or CSF hypertension. Most of traumatic type stop spontaneously within a week to 6 months. Anosmia and meningitis are two main dangers of it. In Nontraumatic type, there is greater flow of CSF. Side is not constant. Headache is common than anosmia. It’s common in females and >30 years of age. Iatrogenic type is commonly due to neurosurgical and otolaryngotic approaches to neoplastic diseases and functional endoscopic sinus surgery. Hence based on above findings the present study was planned for study of Trans-Nasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhoea. The present study was planned in Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, India. Total 10 cases presented with the watery discharge from left nostril were enrolled in the present study. ENT examination revealed clear watery fluid coming from left nostril on bending forwards which could not be sniffed back which is referred to as the “reservoir sign” and could not stiffen the handkerchief, which is called “Handkerchief sign”. Diagnostic Nasal Endoscopy revealed clear pulsatile watery discharge from left sphenoid sinus. The present study of CSF rhinorrhoea concludes that commonest cause of CSF rhinorrhoea found to be spontaneous in nature, while trauma comes next among our patients. The 11 to 50 yrs of age and Female are the commonest age group affected, Proper clinical history and investigations will identify the leaks and the site of leak and whether there is associated meningoencephalocele or not. Spontaneous CSF rhinorrhoea found to be higher than traumatic, and most patients either spontaneous or traumatic presented with the meningoencephalocele. In our study the most common site of CSF rhinorrhoea found to be in cribriform plate, next being anterior ethmoid while posterior ethmoid, sphenoid and frontal areas relatively less common.