Cerebrospinal fluid rhinorrhea [Neurosurgery Wiki]

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====== Cerebrospinal fluid rhinorrhea ======

===== Etiology =====

Common etiologies of CSF rhinorrhea include trauma, neoplasms, and prior surgery, while CSF otorrhea is usually associated with craniocerebral trauma, neurosurgical procedures, or other conditions; however, both conditions may occur spontaneously
((May JS, Mikus JL, Matthews BL, Browne JD. Spontaneous cerebrospinal fluid otorrhea from defects of the temporal bone: a rare entity? Am J Otol. 1995 Nov;16(6):765-71. PMID: 8572139.)).

[[Nontraumatic cerebrospinal fluid fistula]]

[[Traumatic cerebrospinal fluid rhinorrhea]]

[[Sphenoid lateral recess Cerebrospinal fluid fistula]]

Through [[cribiform plate]]

Endoscopic CSF fistula closure is a safe and effective operation. All sites of leak can be accessed endoscopically 
((Virk JS, Elmiyeh B, Saleh HA. Endoscopic management of cerebrospinal fluid
rhinorrhea: the charing cross experience. J Neurol Surg B Skull Base. 2013
Apr;74(2):61-7. doi: 10.1055/s-0033-1333620. Epub 2013 Feb 13. PubMed PMID:
24436890; PubMed Central PMCID: PMC3699213.)).


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Macroprolactinomas (MPRLs) may result in nonsurgical (spontaneous or dopamine agonist induced) cerebrospinal fluid (CSF) rhinorrhea; however, the incidence of and mechanisms underlying this phenomenon are poorly understood
((Suliman SG, Gurlek A, Byrne JV, Sullivan N, Thanabalasingham G, Cudlip S,
Ansorge O, Wass JA. Nonsurgical cerebrospinal fluid rhinorrhea in invasive
macroprolactinoma: incidence, radiological, and clinicopathological features. J
Clin Endocrinol Metab. 2007 Oct;92(10):3829-35. Epub 2007 Jul 10. PubMed PMID:
17623759.
)).