Endoscopic CSF Leak Repair
CSF rhinorrhea refers to cerebrospinal fluid (“brain fluid”) leakage through the nose. The fluid is usually clear and watery in consistency. This is in contrast to mucus from the nose which is sticky and thicker in consistency.
What is a CSF Leak?
The roof of the nose and sinus cavities is the floor of the brain, called the skull base. It is made of bone. if there is a hole in this bone as well as a tear in the dura – the tough, leathery casing surrounding the brain – then CSF can leak through.
How does a leak happen?
There are several causes of a CSF leak :
- Trauma – with severe blows to the head, the skull base can fracture and the brain casing (dura) can tear. This will allow CSF to leak into the nasal cavity.
- Prior surgery – surgery of the sinuses or skull base can lead to a breach of the bone and CSF can leak through the defect.
- Congenital – there can be congenital defect in the skull base bone
- Tumors – A CSF leak may be the first sign of a tumor growing in the skull base, nasal, or sinus cavities.
- Spontaneous CSF leak – A CSF leak into the nose can occur spontaneously and with no obvious explanation. Further investigation may support that this is a variant of benign intracranial hypertension in is which there is an overproduction of CSF. If there is more CSF produced than the drainage system can keep up with, a path of least resistance forms and this may be through the nose.
What is endoscopic repair?
Using telescopes and cameras, we can visualize the site of the defect and patch it. This may require placement of a lumbar drain and a stay in the hospital for a few days.
What do I do if I suspect I have one?
See your family physician ASAP and obtain a referral to see a rhinologist.
Until the appointment, do not blow your nose and avoid strenuous activity. Take measures not to catch a cold.
Dr. Stephanie Joe is Chicagoland’s CSF Leak Repair surgeon of choice. If you have further questions, please contact us to set up an appointment.