Document Detail


Spontaneous cerebrospinal fluid rhinorrhea: a clinical and anatomical study.
MedLine Citation:
PMID:  20717949     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: Spontaneous nasal cerebrospinal fluid (CSF) fistula represents a rare clinical entity. The possible etiology and the localization of the rhinorrhea remain an ongoing clinical challenge. The purpose of this study was to evaluate the localization of spontaneous CSF fistula and to correlate it with anatomical studies. STUDY DESIGN: Retrospective clinical study, prospective anatomical study. METHODS: Twenty-nine patients with spontaneous CSF rhinorrhea were retrospectively studied, 10 males and 19 females. Ages ranged from 10 to 92 years (mean, 50 years). In addition, 48 human skulls from newborns to adults were examined for the postnatal development of the anterior and middle cranial fossa. RESULTS: In our study isolated cribriform plate defects were found in four patients. The lateral lamina of the ethmoid bone showed defects in three patients. In nine patients the bony defect could be found in the region of the fovea ethmoidalis. The bony defect between the extra- and intracranial space was found in the lateral recess of the sphenoid sinus in eight patients. Five patients had special sites (e.g., supraorbital recess and frontal recess). CONCLUSIONS: This study supports the theory that bony dehiscence in the lateral lamina of the ethmoid bone can be congenital and can also be spontaneously acquired later. The bony dehiscence in the lateral wall of the sphenoid sinus can only develop during pneumatization.
Authors:
Miklós Tóth; Oxana Selivanova; Steven Schaefer; Wolf Mann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  120     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-09-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1724-9     Citation Subset:  IM    
Affiliation:
Department of Otorhinolaryngology, Johannes Gutenberg University Medical School, Mainz, Germany. toth@hno.klinik.uni-mainz.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Aged
Aged, 80 and over
Cerebrospinal Fluid Rhinorrhea / congenital,  diagnosis*,  pathology*,  surgery
Child
Cranial Fossa, Anterior / pathology*
Cranial Fossa, Middle / pathology*
Ethmoid Bone / pathology,  surgery
Ethmoid Sinus / pathology,  surgery
Female
Frontal Sinus / pathology
Humans
Infant, Newborn
Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Risk Factors
Sphenoid Bone / pathology,  surgery
Sphenoid Sinus / pathology,  surgery
Tomography, X-Ray Computed
Young Adult

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