Post traumatic cerebrospinal fluid rhinorrhea: a descriptive study

Authors

  • Malavika Madathumpadikal Department of ENT, Head and Neck Surgery, Carewell Hospital, Kasaragod, Kerala, India
  • Mathew Dominic Department of ENT, Head and Neck Surgery, Medical Trust Hospital, Kochi, Kerala, India
  • Preethy Mary Department of ENT, Head and Neck Surgery, Medical Trust Hospital, Kochi, Kerala, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20243502

Keywords:

Cerebrospinal fluid, Post traumatic cerebrospinal fluid rhinorrhea, Traumatic CSF rhinorrhea

Abstract

Background: Post-traumatic CSF rhinorrhea occurs following head trauma or after intracranial surgery. Traumatic CSF rhinorrhea can be detrimental with complications such as bacterial meningitis.

Methods: Retrospective review of hospital records of post-traumatic patients admitted under neurosurgery department from 2016-2021 was done. 66 patients with CSF rhinorrhea were identified. Their mode of trauma, management and radiological images were reviewed and recorded.

Results: Out of the 66 patients, 87.8% were males and average age group 20-30years. 41 resolved with conservative management. Frontal bone was most common site of rhinorrhea. In 61.8% (n=41) patients, fracture was seen in more than one bone/anatomical site. Incidence of post-traumatic CSF rhinorrhea in this study in 6.6%.

Conclusions: Early diagnosis and management are important to prevent complications. In majority of cases, the leak subsides with conservative management, hence early surgical intervention is not required.

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References

Mincy JE. Posttraumatic cerebrospinal fluid fistula of the frontal fossa JTrauma. 1966;6(5):618–22.

Schneider RC, Thompson JM. Chronic and delayed traumatic cerebrospinal rhinorrhea as a source of recurrent attacks of meningitis. Ann Surg. 1957;145(4):517.

Hirsch O: Successful closure of cerebrospinal fluid rhinorrhea by endonasal surgery. AMA Arch Otolaryngol. 1952;56(1):1–12.

Ray BS, Bergland RM. Cerebrospinal fluid fistula: clinical aspects, techniques of localization, and methods of closure. J Neurosurg. 1969;30(4):399-405.

Oakley GM, Alt JA, Schlosser RJ, Harvey RJ, Orlandi RR. Diagnosis of cerebrospinal fluid rhinorrhea: an evidence-based review with recommendations. Int Forum Allergy Rhinol. 2016;6(1):8-16

Badr Eldin Mostafa, Ahmed Khafagi: Combined HRCT and MRI in the Detection of CSF Rhinorrhea.Skull Base. 2004;14(3):157-62.

Nasiru Jinjiri Ismail, Ali Lasseini, Aliyu Muhammad Koko, Bello Bala Shehu. Management and outcome of post-traumatic cerebrospinal fluid rhinorrhea. Int J Res Med Sci. 2020;8(3):937-40.

8. Mustafa Tajelsir, Nazik Elfadil, Mohamed Elawad. Management and outcome of treatment modalities of cerebrospinal fluid rhinorrhea.Pan arab journal of rhinology.2020;10(2):63-8.

Bryan Bell R, Dierks EJ, Homer L, Potter BE. Management of cerebrospinal fluid leak associated with craniomaxillofacial trauma, J Oral Maxillofac Surg. 2004;62(6):676-84.

Jonathan A Friedman, M D Michael, J Ebersold, MD., and LYNN M. Quast, R.N. Persistent posttraumatic cerebrospinal fluid leakage. Neurosurg Focus. 2000;9(1):1-5.

Broadie H, Thompson TC: Management of complications from 820 temporal bone fractures. Am J Otol. 1997;18:188-97.

Ji-Woong Oh, So-Hyun Kim, Kum Whang: Traumatic Cerebrospinal Fluid Leak: Diagnosis and Management. Korean J Neurotrauma. 2017;13(2): 63-7.

Banks CA, Palmer JN, Chiu AG, O’Malley BW, Woodworth BA, Kennedy DW. Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years. Otolaryngol Head Neck Surg. 2009;140:826-33.

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Published

2024-11-26

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Original Research Articles