Harley Benjamin, Wickremesekera Agadha, Tan Neil, Davies Elgan, Robinson Simon, Baguley Campbell, Wormald Peter J
Department of Neurosurgery, Wellington Hospital, Riddiford Street, Newtown, Wellington 6021, New Zealand.
Department of Neurosurgery, Wellington Hospital, Riddiford Street, Newtown, Wellington 6021, New Zealand.
J Clin Neurosci. 2019 Jan;59:350-352. doi: 10.1016/j.jocn.2018.10.020. Epub 2018 Nov 3.
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.
我们报告了两名分别为16岁和33岁的女性患者，她们表现为自发性脑脊液鼻漏。两例患者的β-2转铁蛋白均呈阳性。最初的高分辨率CT显示上颌窦内有液体，但无明显骨质缺损。磁共振成像显示上颌窦囊肿在T2序列上呈高信号。采用鞘内注射荧光素的鼻内镜经鼻手术，两例均发现圆孔处有漏口并进行了修复。两名患者在6个月时均无症状。这些病例突出了圆孔自发性脑脊液漏的罕见情况，以及如何通过鼻内镜经鼻入路有效地进行修复。
