scholarly journals Cerebrospinal Fluid Rhinorrhoea in Pituitary Tumours

1980 ◽  
Vol 73 (4) ◽  
pp. 244-254 ◽  
Author(s):  
I E Cole ◽  
Malcolm Keene
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Tumours ◽  
Pituitary Fossa ◽  
Muscle Graft ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea

Three cases of CSF rhinorrhoea due to pituitary tumours are reported and the literature reviewed. The treatment of choice appears to be trans-sphenoidal exploration of the pituitary fossa with insertion of a free muscle graft followed by radiotherapy. The probability of the tumour being a prolactin-secreting adenoma is discussed.

Meningitis after trans-sphenoidal excision of pituitary tumours

1988 ◽  
Vol 102 (1) ◽  
pp. 33-36 ◽  
Author(s):  
W. R. Gransden ◽  
M. Wickstead ◽  
Susannah J. Eykyn
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Tumours ◽  
Sphenoidal Sinus ◽  
Muscle Graft ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Nasal Pack

SummaryBetween 1974 and 1986, eleven of 114 patients undergoing trans-sphenoidal removal of pituitary tumours developed meningitis despite prophylaxis, usually with chloramphenicol. Nine patients had cerebrospinal fluid rhinorrhoea and one died. A variety of pathogens was isolated, including enterobacteria, and four of the eleven were resistant to the antibiotics given as prophylaxis. Enterobacterial meningitis was always associated with infection of the sphenoidal sinus involving the muscle graft or nasal pack (five cases), and removal of the muscle graft was necessary in three cases despite the use of appropriate antibiotics.

Cerebrospinal fluid rhinorrhoea during treatment of pituitary tumours with bromocriptine

1983 ◽  
Vol 103 (4) ◽  
pp. 457-460 ◽  
Author(s):  
J. Dennis Wilson ◽  
Raymond L. G. Newcombe ◽  
Francis L. Long
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Tumours ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea

Abstract. Bromocriptine is widely used in the treatment of hyperprolactinaemia. It has also been shown to be effective in reducing the size of large pituitary tumours, particularly those secreting prolactin. We describe CSF rhinorrhoea in two such patients during treatment with bromocriptine and believe that this complication developed as a result of contraction of the tumour exposing a defect in the sella floor. The possibility of this complication, especially in patients with downward extension of tumour, should be noted.

Use of protein electrophoresis in the diagnosis of cerebrospinal fluid rhinorrhoea

1992 ◽  
Vol 106 (6) ◽  
pp. 504-506 ◽  
Author(s):  
M. J. Porter ◽  
G. B. Brookes ◽  
A. Z. J. Zeman ◽  
G. Keir
Keyword(s):  
Cerebrospinal Fluid ◽  
Diagnostic Accuracy ◽  
Tau Protein ◽  
Electrophoretic Analysis ◽  
Protein Electrophoresis ◽  
Csf Leak ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea ◽  
Nasal Secretions

AbstractThe diagnosis of CSF rhinorrhoea on clinical grounds alone can be difficult. We describe how the use of noninvasive electrophoretic analysis of nasal secretions for tau protein (asialotransferrin) helped in the management of cases where the existence of a CSF leak was in doubt. Patients were thus saved unnecessary invasive investigations or surgery. A modification of the method of analysis, which improves diagnostic accuracy, is described.

The management of massive pneumocephalus and cerebrospinal fluid rhinorrhoea as a consequence of biopsy in a patient with inverted papilloma

1998 ◽  
Vol 112 (7) ◽  
pp. 657-659 ◽  
Author(s):  
U. S. Kale ◽  
S. G. Raje ◽  
R. G. Wight
Keyword(s):  
Cerebrospinal Fluid ◽  
Nasal Polyps ◽  
Inverted Papilloma ◽  
Successful Outcome ◽  
Csf Leak ◽  
Lateral Rhinotomy ◽  
Endoscopic Repair ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea

AbstractNasal polypectomy is a common ENT operation. Cerebrospinal fluid (CSF) rhinorrhoea and pneumocephalus are rare complications. We present a patient who developed both these complications after biopsy of nasal polyps which subsequently proved to be an inverted papilloma. He had a defect in the ethmoid roof, which was repaired.Whilst endoscopic repair of CSF leak is increasing in popularity, in this patient because of his pathology and difficulty of access a more traditional lateral rhinotomy approach was made with a successful outcome. An overview of the management of these complications is presented.

Bilateral cerebrospinal fluid rhinorrhoea

2000 ◽  
Vol 114 (2) ◽  
pp. 137-138 ◽  
Author(s):  
James D. Ramsden ◽  
Rogan Corbridge ◽  
Grant Bates
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Surgical Approach ◽  
Subarachnoid Space ◽  
Complication Rates ◽  
Endoscopic Repair ◽  
Csf Fistula ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Csf Rhinorrhoea ◽  
Csf Leaks

Cerebrospinal fluid (CSF) rhinorrhoea is leakage of fluid from the subarachnoid space to the frontal, sphenoidal or ethmoidal sinuses, and may occur spontaneously. The authors present the first reported case of bilateral spontaneous CSF rhinorrhoea. Bony defects on both sides of the cribriform plate were identified using endoscopic and radiological techniques, and the CSF fistula was closed endoscopically. The aetiology, diagnosis and contemporary surgical treatment of spontaneous CSF leaks is discussed. Endoscopic repair was successful in this case, and in view of the high success and low reported complication rates this surgical approach should be considered for treatment of spontaneous CSF rhinorrhoea.

scholarly journals Cerebrospinal Fluid Rhinorrhea as the First Symptom of Metastatic Prostate Adenocarcinoma

2021 ◽  
pp. 014556132110167
Author(s):  
Magdalena Ostrowska ◽  
Maciej J. Wróbel
Keyword(s):  
Prostate Cancer ◽  
Cerebrospinal Fluid ◽  
Paranasal Sinuses ◽  
Cancer Metastasis ◽  
Treatment Strategies ◽  
Prostate Adenocarcinoma ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Csf Leakage ◽  
Prostate Cancer Metastasis ◽  
Csf Rhinorrhoea

The most common cause of cerebrospinal fluid (CSF) rhinorrhoea is damage to the skull base with a dura mater’s rupture due to an accident or an iatrogenic injury. This applies to over 96% of cases. Other possibilities that can lead to CSF leakage are neoplasms of the nasal cavity, paranasal sinuses, and nasopharynx. Although prostate cancer spreads to bones, cranial metastases to paranasal sinuses are extremely rare. We present a case of an 83-year-old patient with CSF leakage due to infiltrating metastatic prostate cancer. Cerebrospinal fluid rhinorrhea turned out to be the first symptom of prostate cancer metastasis. Diagnostic and treatment strategies are presented in the discussion.

Extradural cartilage inlay graft in cerebrospinal fluid fistula repair

2010 ◽  
Vol 124 (12) ◽  
pp. 1294-1297 ◽  
Author(s):  
P Thulasi Das ◽  
D Balasubramanian
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Success Rate ◽  
Bony Defect ◽  
Cerebrospinal Fluid Fistula ◽  
Fistula Repair ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Skull Base Defects ◽  
Fluid Fistula

AbstractObjective:To present our experience in managing cerebrospinal fluid rhinorrhoea using the cartilage inlay (underlay) technique to repair skull base defects larger than 4 mm.Study design:Retrospective study involving patients presenting with cerebrospinal fluid rhinorrhoea between 1994 and 2008.Setting:Patients were treated in a tertiary referral centre for nose and sinus diseases. Patients' medical records were reviewed and analysed.Results:A total of 62 patients were operated upon using a cartilage inlay technique to repair bony skull base defects ranging in size from 4 to 20 mm (widest diameter). Of these 62 patients, 16 constituted revisions of earlier procedures undertaken elsewhere. The success rate of the technique was 100 per cent. Patient follow up ranged from six months to 16 years, with a median follow up of 15 months. Three patients had minor post-operative sinus infections; no serious complications were encountered.Conclusion:Extradural cartilage inlay appears to be an effective technique in the management of cerebrospinal fluid rhinorrhoea, especially for large defects and revision procedures. To our knowledge, the described patients represent the largest reported series of cerebrospinal fluid rhinorrhoea cases managed using the cartilage inlay technique. We believe that the crucial factors in our high success rate for cerebrospinal fluid fistula repair are: precise identification of the bony defect; meticulous preparation of the graft bed; careful elevation of the dura; judicious use of just enough graft tissue; and adequate graft support.

scholarly journals Cerebrospinal fluid rhinorrhoea following transsphenoidal surgery for pituitary adenoma: experience in a Chinese centre

2017 ◽  
Vol 37 (4) ◽  
pp. 303-307
Author(s):  
C. Zhang ◽  
X. Ding ◽  
Y. Lu ◽  
L. Hu ◽  
G. Hu
Keyword(s):  
Cerebrospinal Fluid ◽  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Cerebrospinal Fluid Rhinorrhoea ◽  
Sono Stati ◽  
Fattori Di Rischio ◽  
Adenoma Ipofisario

Lo scopo del presente studio è stato quello di chiarire i fattori di rischio della rinoliquorrea a seguito di un approccio transfenoidale e di discuterne la prevenzione e il trattamento. Abbiamo revisionato retrospettivamente 474 casi consecutivi di adenoma ipofisario trattati con 485 procedure chirurgiche per via transfenoidale da Gennaio 2008 a Dicembre 2011 nel nostro dipartimento. Abbiamo analizzato l’incidenza di fuoriuscita di liquor cefalorachidiano intraoperatoriamente e nel postoperatorio, e la riuscita di varie strategie di riparazione. Abbiamo riscontrato fuoriuscita di liquor intraoperatoriamente in 85 casi (17.9%) e postoperatoriamente in 13 casi (2.7%). Sette dei 13 pazienti con rinoliquorrea postoperatoria non avevano mostrato fuoriuscita di liquor intraoperatoriamente; tre di questi pazienti avevano adenomi secernenti ADH. Dei rimanenti 6 pazienti con fuoriuscita di liquor sia intra che postoperatoria, 2 erano stati trattati per prolattinoma gigante e invasivo e 2 erano già stati sottoposti in passato a chirurgia trasnfenoidale. In 8 pazienti la fuoriuscita è stata risolta mediante puntura lombare, drenaggio lombare, riposo in posizione semi-reclinata o altri trattamenti conservativi. Due casi sono stati trattati mediante schiuma di gelatina e colla di fibrina utilizzando un approccio transfenoidale e due con grasso autologo e ricostruzione del pavimento della sella utilizzando un approccio transnasale endoscopico. Dopo essere stato sottoposto a due tentativi di riparazione per via transasale, un paziente è stato trattato con successo mediante un ulteriore drenaggio subaracnoideo. In conclusone le procedure che fanno uso di schiuma di gelatina, colla di fibrina e impianti di grasso autologo sono efficaci ai fini del trattamento della rinoliquorrea postoperatoria in pazienti sottoposti a chirurgia transfenoidale. Quando viene rilevata una perdita di liquido cefalorachidiano in corso di chirurgia transfenoidale, un’appropriata ricostruzione del pavimento della sella e un follow up a lungo termine sono necessari.

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