Spontaneous cerebrospinal fluid rhinorrhea; A case report.

A 46-year-old male had complained of persistent rhinorrhea since October 24, 1988. Two days after the onset of rhinorrhea be developed meningitis.Plain X-ray and tomography revealed a fluid shadow in the sphenoid sinus. RI cisternography (111In-DTPA) showed evidence of a CSF leak. The precise site of the CSF leakage could be detected by metrizamide CT. Surgery was performed through a transmaxillary approach under an operating microscope.Several small holes were found in the posterior wall of the sphenoid sinus.The leak site was covered with femoral fascia and muscle. He has remained symptomfree 14 months postoperatively. Metrizamide CT is usefull to determine the precise leak site in patients with active leaks.