Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature
Spontaneous cerebrospinal fluid (CSF) rhinorrhea develops in patients without any history of trauma. Multiple factors have been theoretically debated. Also, localizing the defect may result in a challenge for the rhinologist. The common locations are the cribriform plate and the lateral recess of th...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Case Reports in Otolaryngology |
| Online Access: | http://dx.doi.org/10.1155/2023/3205191 |
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| author | Maryam Aljawi Mahdi Shkoukani |
| author_facet | Maryam Aljawi Mahdi Shkoukani |
| author_sort | Maryam Aljawi |
| collection | DOAJ |
| description | Spontaneous cerebrospinal fluid (CSF) rhinorrhea develops in patients without any history of trauma. Multiple factors have been theoretically debated. Also, localizing the defect may result in a challenge for the rhinologist. The common locations are the cribriform plate and the lateral recess of the sphenoid. Clival CSF rhinorrhea is rare, and only few cases have been reported so far. A 52-year-old female presented to the otolaryngology clinic with 7 years of history of left-side clear fluid rhinorrhea as a drop, which progressed to be runnier after she had pneumonia with severe cough secondary to COVID-19 infection. CSF was confirmed by a beta-2-transferrin test. During the perioperative evaluation, she developed meningitis which was treated with IV ceftriaxone and IV vancomycin antibiotics. The magnetic resonance imaging (MRI) and computerized tomography (CT) scan showed clival defect with pseudomeningocele which was initially not easy to see on CT. The patient underwent an endoscopic approach to the skull base to repair the defect with a pedicled septal flap. Also, a lumbar drain with intrathecal fluorescein administration was utilized. The postoperative course was uneventful without any complications. There was no evidence of recurrence with a 9-month follow-up postoperatively. |
| format | Article |
| id | doaj-art-6e7cefb4d5b84166a22ffb5480f27408 |
| institution | Kabale University |
| issn | 2090-6773 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Otolaryngology |
| spelling | doaj-art-6e7cefb4d5b84166a22ffb5480f274082025-08-20T03:33:54ZengWileyCase Reports in Otolaryngology2090-67732023-01-01202310.1155/2023/3205191Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of LiteratureMaryam Aljawi0Mahdi Shkoukani1Otolaryngology Head and Neck Surgery Cleveland ClinicOtolaryngology Head and Neck Surgery Cleveland ClinicSpontaneous cerebrospinal fluid (CSF) rhinorrhea develops in patients without any history of trauma. Multiple factors have been theoretically debated. Also, localizing the defect may result in a challenge for the rhinologist. The common locations are the cribriform plate and the lateral recess of the sphenoid. Clival CSF rhinorrhea is rare, and only few cases have been reported so far. A 52-year-old female presented to the otolaryngology clinic with 7 years of history of left-side clear fluid rhinorrhea as a drop, which progressed to be runnier after she had pneumonia with severe cough secondary to COVID-19 infection. CSF was confirmed by a beta-2-transferrin test. During the perioperative evaluation, she developed meningitis which was treated with IV ceftriaxone and IV vancomycin antibiotics. The magnetic resonance imaging (MRI) and computerized tomography (CT) scan showed clival defect with pseudomeningocele which was initially not easy to see on CT. The patient underwent an endoscopic approach to the skull base to repair the defect with a pedicled septal flap. Also, a lumbar drain with intrathecal fluorescein administration was utilized. The postoperative course was uneventful without any complications. There was no evidence of recurrence with a 9-month follow-up postoperatively.http://dx.doi.org/10.1155/2023/3205191 |
| spellingShingle | Maryam Aljawi Mahdi Shkoukani Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature Case Reports in Otolaryngology |
| title | Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature |
| title_full | Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature |
| title_fullStr | Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature |
| title_full_unstemmed | Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature |
| title_short | Clival Defect Resulting in Spontaneous Cerebrospinal Fluid Rhinorrhea: Case Report and Review of Literature |
| title_sort | clival defect resulting in spontaneous cerebrospinal fluid rhinorrhea case report and review of literature |
| url | http://dx.doi.org/10.1155/2023/3205191 |
| work_keys_str_mv | AT maryamaljawi clivaldefectresultinginspontaneouscerebrospinalfluidrhinorrheacasereportandreviewofliterature AT mahdishkoukani clivaldefectresultinginspontaneouscerebrospinalfluidrhinorrheacasereportandreviewofliterature |