Nontraumatic Cerebrospinal Fluid Rhinorrhea via the Middle Cranial Fossa and Sphenoid Sinus: A Case Report

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  • Kansaku Kenji
    Departments of Neurosurgery, School of Medicine, Chiba University
  • Kubota Motoo
    Departments of Neurosurgery, School of Medicine, Chiba University
  • Kobayashi Eiichi
    Departments of Neurosurgery, School of Medicine, Chiba University
  • Saeki Naokatsu
    Departments of Neurosurgery, School of Medicine, Chiba University
  • Yamaura Akira
    Departments of Neurosurgery, School of Medicine, Chiba University
  • Konno Akiyoshi
    Departments of Otolaryngology, School of Medicine, Chiba University

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  • 中頭蓋底より蝶形骨洞へ髄液の流出を認めた非外傷性髄液鼻漏の1例 : 術前画像診断の有用性と解剖学的特徴について

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Abstract

A rare case of nontraumatic cerebrospinal fluid (CSF) rhinorrhea is reported. A 54-year-old man with spontaneously occurring CSF rhinorrhea was admitted to our institution. A bone-window CT scan showed bilateral extension of the sphenoid sinus into the greater wings. Multiple bony defects were revealed in the anteromedial portion of the right middle cranial fossa. A CT cisternogram clearly demonstrated efflux of the contrast medium from the middle cranial fossa into the sphenoid sinus. The bony defects were successfully repaired, and the rhinorrhea resolved completely. The patient was discharged in satisfactory condition. Nontraumatic CSF rhinorrhea associated with bony defects_ in the middle cranial fossa is rare, and to the authors' knowledge only 18 cases have been reported in the literature. The features and etiology are reviewed, using the measurement of the size of the sphenoid sinus (16 Japanese subjects).

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