Endoscopic transnasal repair of two cases of spontaneous cerebrospinal fluid fistula in the foramen rotundum

J Clin Neurosci. 2019 Jan:59:350-352. doi: 10.1016/j.jocn.2018.10.020. Epub 2018 Nov 3.

Abstract

We report two female patients aged 16 and 33 who presented with spontaneous cerebrospinal fluid (CSF) rhinorrhoea. Beta-2 transferrin was positive in both cases. Initial high-resolution CT showed fluid in the maxillary sinus but no obvious bony defect. MR imaging revealed maxillary sinus cysts with high signal on T2 sequences. Endoscopic transnasal surgery with intrathecal fluorescein was undertaken and in both cases a leak was identified from foramen rotundum and repaired. Both patients are symptom free at 6 months. These cases highlight the rare occurrence of spontaneous CSF leak from the foramen rotundum, and how they can be effectively repaired using the endoscopic transnasal approach.

Keywords: Cerebrospinal fluid; Foramen rotundum; Rhinorrhoea.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Cerebrospinal Fluid Rhinorrhea / surgery*
  • Cysts / surgery
  • Female
  • Fistula / surgery
  • Humans
  • Male
  • Natural Orifice Endoscopic Surgery / adverse effects
  • Natural Orifice Endoscopic Surgery / methods*
  • Postoperative Complications