[Cerebrospinal fluid rhinorrhea from a transclival meningocele: A case report and literature review]. / Rinorraquia secundaria a meningocele transclival. A propósito de un caso y revisión de la literatura.

The most common site of CSF leakage is the floor of the anterior cranial fossa, and less commonly in the sphenoid sinus. Only 3-4% of CSF fistulas are spontaneous. The fourth case is presented of a CSF rhinorrhea due to a transclival meningocele, an extremely rare location for these lesions, and the surgical approach. The patient is a 39-year-old male with no history of trauma, and a recent history of watery rhinorrhe and meningitis. CT scan and MRI showed clival bone defect and trans-sphenoidal transclival meningocele. The defect was repaired by transclival trans-sphenoidal endoscopic endonasal approach with good results. Despite the rarity of transclival meningocele, it is recommended to consider it in the differential diagnosis of spontaneous nasal fistulas. The endoscopic endonasal approach is a direct technique that provides satisfactory results in the resolution of CSF rhinorrhea.

Two Cases of Spontaneous Cerebrospinal Fluid Rhinorrhea by Idiopathic Bony Defects / 대한이비인후과학회지

Cerebrospinal fluid rhinorrhea can be caused by head trauma, brain or sinus surgery or neoplastic sinonasal disease. In addition, CSF rhinorrhea may develop spontaneously in some cases. We experienced two cases of spontaneous CSF rhinorrhea caused by idiopathic bony defect. The first case was a 47-year old female who complained of a persistent rhinorrhea for 2 months without surgical or traumatic history. The second case was a 40-year old female. Having no surgical or traumatic history, she also suffered from a persistent rhinorrhea for thirteen years. For diagnosis of CSF rhinorrhea, we carried out endoscopic examination, glucose test of rhinorrhea, computed tomograph, magnetic resonance imaging and (99m)Tc-DTPA cisternography. We found bony defect in the cribriform plate of the two cases. Patients were treated successfully with endoscopic approach. Leak sites were repaired with free graft materials. There has not been any recurrence or complications since the endoscopic closure.