Etiologic factors in spontaneous CSFrhinorrhea

to highlight the underlying etiologic factors identified in a case series of patients with spontaneous CSF rhinorrhea. A retrospective review of 14 patients with spontaneous CSF rhinorrhea evaluated and managed over a 4 years period was conducted. All patients were assessed by history taking, ENT examination including nasal endoscopy and CT scan with intrathecal metrizamide. Surgical exploration and repair of the CSF leak were conducted in 11 patients. in 7 patients, the cause of the CSF rhinorrhea could be identified from the nasal endoscopic and radiological findings. In this group of patients, cephaloceles and empty sella syndrome were the responsible etiological factors. In another 7 patients, the source of the leak was small meningoceles in the sinonasal region identified only upon endoscopic surgical exploration. Cephaloceles and empty sella syndrome are the main etiologic factors for spontaneous CSF rhinorrhea. In patients with spontaneous CSF rhinorrhea and inconclusive diagnostic findings, surgical exploration is warranted for identification of the source of the leak and its repair

Juvenile angiofibroma: a 4-year surgical experience

Ten patients with histologically confirmed juvenile angiofibroma were included in this study. All patients were surgically managed requiring a total of 13 procedures to control their disease: Nine midfacial degloving procedures, three transpalatal procedures and one transnasal endoscopic procedure. Results revealed that there were no major complications and the overall control rate was 90%. Surgical treatment, specifically the midfacial degloving, is recommended as an ideal approach in most patients. The use of endoscopes enhances the surgeon's diagnostic and surgical capabilities for managing the tumor