2008Otolaryngologia PolskaRequires access

Rzadki przypadek płynotoku nosowego

Tomasz Rowicki, Mirosława Pietniczka–Załęska, Krystyna Budzynowska, Justyna Dąbrowska-Bień

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Abstract

INTRODUCTION: Cerebrospinal fluid rhinorrhea is a result of a damage to bones and dura mater of the anterior cranial fossa base. In more than 90% it is of trauamatic etiology. AIM: The aim of the study was to present a case of a 23 year old female patient with post-traumatic rhinorrhea. Cerebrospinal fluid rhinorrhea occured as a result of unintentional damage of cribriform plate of the ethmoid bone on the right side when the patient was opening a box of cosmetic with the use of a screwdriver. MATERIAL AND METHODS: Two days after the accident she was admitted to our Department with apparent cerebrospinal fluid rhinorrhea and forehead headache. Radiological and laboratory testing were performed, than she was consulted by a neurologist and a neurosurgeon. It was decided to introduce conservative management in the ENT department. RESULTS: During 24 days of hospitalization with medical management including avoidance of activities that increased the intracranial pressure, head elevation and antibiotics the cerebrospinal fluid rhinorrhea decreased and ceased. This was confirmed by physical examination, nasal endoscopy, radiological studies and neurosurgical consultation. CONCLUSIONS: After more than 3 months of follow-up, there was no evidence of rhinorrhea.

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What this paper is about

INTRODUCTION: Cerebrospinal fluid rhinorrhea is a result of a damage to bones and dura mater of the anterior cranial fossa base. In more than 90% it is of trauamatic etiology. AIM: The aim of the study was to present a case of a 23 year old female patient with post-traumatic rhinorrhea. Cerebrospinal fluid rhinorrhea occured as a result of unintentional damage of cribriform plate of the ethmoid bone on the right side when the patient was opening a box of cosmetic with the use of a screwdriver. MATERIAL AND METHODS: Two days after the accident she was admitted to our Department with apparent cerebrospinal fluid rhinorrhea and forehead headache. Radiological and laboratory testing were performed, than she was consulted by a neurologist and a neurosurgeon. It was decided to introduce conservative management in the ENT department. RESULTS: During 24 days of hospitalization with medical management including avoidance of activities that increased the intracranial pressure, head elevation and antibiotics the cerebrospinal fluid rhinorrhea decreased and ceased. This was confirmed by physical examination, nasal endoscopy, radiological studies and neurosurgical consultation. CONCLUSIONS: After more than 3 months of follow-up, there was no evidence of rhinorrhea.

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Available abstract

INTRODUCTION: Cerebrospinal fluid rhinorrhea is a result of a damage to bones and dura mater of the anterior cranial fossa base. In more than 90% it is of trauamatic etiology. AIM: The aim of the study was to present a case of a 23 year old female patient with post-traumatic rhinorrhea. Cerebrospinal fluid rhinorrhea occured as a result of unintentional damage of cribriform plate of the ethmoid bone on the right side when the patient was opening a box of cosmetic with the use of a screwdriver. MATERIAL AND METHODS: Two days after the accident she was admitted to our Department with apparent cerebrospinal fluid rhinorrhea and forehead headache. Radiological and laboratory testing were performed, than she was consulted by a neurologist and a neurosurgeon. It was decided to introduce conservative management in the ENT department. RESULTS: During 24 days of hospitalization with medical management including avoidance of activities that increased the intracranial pressure, head elevation and antibiotics the cerebrospinal fluid rhinorrhea decreased and ceased. This was confirmed by physical examination, nasal endoscopy, radiological studies and neurosurgical consultation. CONCLUSIONS: After more than 3 months of follow-up, there was no evidence of rhinorrhea.

Key concepts: Medicine, rhinorrhea, Cribriform plate, Cerebrospinal Fluid Rhinorrhea, Neurosurgery, Surgery, Ethmoid bone, Forehead

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