ABSTRACT
Cerebrospinal fluid (CSF) rhinorrhea is a dangerous problem. CSF rhinorrhea implies an abnormal communication between the subarachnoid space and the nasal cavity, with subsequent leakage of CSF through the anterior nasal apertures. requiring surgical repair. Imaging techniques have evolved from conventional cranial radiography to polytomography, thin-section computed tomography (CT) and intrathecal water-soluble iodinated contrast agent-enhanced CT cisternography. We present two cases of post-surgical CSF rhinorrhea in which the best diagnostic findings were obtained by CT cisternography.
ABSTRACT
PURPOSE: To assess ultrasonography in the evaluation of reactions after soft tissue augmentation of the face with synthetic materials. MATERIAL AND METHODS: Six female patients (mean age 39+/-8 years) treated for facial tissue augmentation noticed unpleasant or painful effects in the intervention site after a mean of 24 months were evaluated with ultrasonography. Two patients had been treated with injections of microparticles, two with Gore-Tex implants, and two had been injected with liquid silicone. Fifteen female patients (age 27-55 years, mean 41+/-14 years) who had received the same treatment 14-48 months before without any complications were also evaluated and used as controls. Biopsy was performed in all patients, while four underwent re-intervention. RESULTS: In all patients with Gore-Tex implants, a thick, homogeneous hypoechoic halo was seen surrounding the implants. Small hypoechoic nodules were noticed in the patients who had been treated with microparticles and with liquid silicone. In two cases treated with liquid silicone the subcutaneous tissue was invaded by an irregular area of marked inhomogeneity. CONCLUSION: Sonography must be considered the method of choice for producing instrumental evidence of foreign body reactions after soft tissue augmentation of the face with synthetic materials.
