Dong D. · Chen X. · Cai F. · Huang S. · Li C. · Zhao Y.

Author affiliations

Department of Rhinology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent via DeepDyve Unlimited fulltext viewing of this article Organize, annotate and mark up articles Printing and downloading restrictions apply

Start free trial

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

Received: June 04, 2022
Accepted: February 17, 2023
Published online: April 19, 2023

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 4

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

Abstract

Introduction: Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) is the most common type of cerebrospinal fluid leakage and may cause serious cerebral complications. The aim of this research was to investigate the relationship between the degree of pneumatization variants of the paranasal sinus and skull base and the incidence of SCSFR. Methods: In total, 131 patients with SCSFR were analyzed, and 50 patients suffering from the nasal septal deviation were selected as controls. The pneumatization of the paranasal sinus and skull base was observed by CT scan. Results: Among the 137 fistulas, 55 (40.15%) were found in the ethmoid sinus. The incidences of Onodi cells (27.27 vs. 8%) and type 3 lateral recess of the sphenoid sinus (LRSS, 70.37 vs. 22%) in the SCSFR subgroups were significantly higher than those in the control group (p < 0.05). Moreover, the occurrence of SCSFR was linearly correlated with the classification of Onodi cells and LRSS (p < 0.05). There was no significant difference in the incidence of frontal cells, anterior clinoid process pneumatization, and posterior clinoid process pneumatization between the SCSFR patients and the controls. Conclusion: The most common site of SCSFR is the ethmoid sinus. The excessive pneumatization of the Onodi cell and LRSS increases the risk for the occurrence of SCSFR in the ethmoid sinus and sphenoid sinus, respectively. The possible association between the paranasal sinus ontogeny and SCSFR pathophysiology needs further studies.

© 2023 S. Karger AG, Basel

References Low CM, Kim DK, Smith AJ, Yin LX, Smith BM, Stokken JK, et al. Association of bone mineral density of the anterior cranial base, obesity, and spontaneous cerebrospinal fluid rhinorrhea. Int Forum Allergy Rhinol. 2021;11(4):804–6. Psaltis AJ, Schlosser RJ, Banks CA, Yawn J, Soler ZM. A systematic review of the endoscopic repair of cerebrospinal fluid leaks. Otolaryngol Head Neck Surg. 2012;147(2):196–203. Englhard AS, Volgger V, Leunig A, Meßmer CS, Ledderose GJ. Spontaneous nasal cerebrospinal fluid leaks: management of 24 patients over 11 years. Eur Arch Otorhinolaryngol. 2018;275(10):2487–94. Lobo BC, Baumanis MM, Nelson RF. Surgical repair of spontaneous cerebrospinal fluid (CSF) leaks: a systematic review. Laryngoscope Investig Otolaryngol. 2017;2(5):215–24. Georgalas C, Oostra A, Ahmed S, Castelnuovo P, Dallan I, van Furth W, et al. International consensus statement: spontaneous cerebrospinal fluid rhinorrhea. Int Forum Allergy Rhinol. 2021;11(4):794–803. Zocchi J, Pietrobon G, Lepera D, Gallo S, Russo F, Volpi L, et al. Spontaneous CSF leaks and IIH: a flawless connection? An experience with 167 patients. Laryngoscope. 2021;131(2):E401–7. O’Connell BP, Stevens SM, Xiao CC, Meyer TA, Schlosser RJ. Lateral skull base attenuation in patients with anterior cranial fossa spontaneous cerebrospinal fluid leaks. Otolaryngol Head Neck Surg. 2016;154(6):1138–44. Stucken EZ, Selesnick SH, Brown KD. The role of obesity in spontaneous temporal bone encephaloceles and CSF leak. Otol Neurotol. 2012;33(8):1412–7. Tilak AM, Koehn H, Mattos J, Payne SC. Preoperative management of spontaneous cerebrospinal fluid rhinorrhea with acetazolamide. Int Forum Allergy Rhinol. 2019;9(3):265–9. Sardi ML, Joosten GG, Pandiani CD, Gould MM, Anzelmo M, Ventrice F. Frontal sinus ontogeny and covariation with bone structures in a modern human population. J Morphol. 2018;279(7):871–82. Yazici D. The effect of frontal sinus pneumatization on anatomic variants of paranasal sinuses. Eur Arch Otorhinolaryngol. 2019;276(4):1049–56. Lee WT, Kuhn FA, Citardi MJ. 3D computed tomographic analysis of frontal recess anatomy in patients without frontal sinusitis. Otolaryngol Head Neck Surg. 2004;131(3):164–73. Özdemir A, Bayar Muluk N, Asal N, Şahan MH, Inal M. Is there a relationship between Onodi cell and optic canal?Eur Arch Otorhinolaryngol. 2019;276(4):1057–64. Wiebracht ND, Zimmer LA. Complex anatomy of the sphenoid sinus: a radiographic study and literature review. J Neurol Surg B Skull Base. 2014;75(6):378–82. Burulday V, Muluk NB, Akgul MH, Kaya A, Öğden M. Presence and types of anterior clinoid process pneumatization, evaluated by Multidetector Computerized Tomography. Clin Invest Med. 2016;39(3):E105–10. Burulday V, Akgul MH, Muluk NB, Ozveren MF, Kaya A. Evaluation of posterior clinoid process pneumatization by multidetector computed tomography. Neurosurg Rev. 2017;40(3):403–9. Gharzouli I, Verillaud B, Tran H, Blancal JP, Sauvaget E, Kania R, et al. Value of systematic analysis of the olfactory cleft in case of cerebrospinal rhinorrhea: incidence of olfactory arachnoid dilatation. Eur Arch Otorhinolaryngol. 2016;273(7):1643–7. Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015. Circulation. 2018 May 29;137(22):2344–56. Wormald PJ, Hoseman W, Callejas C, Weber RK, Kennedy DW, Citardi MJ, et al. The international frontal sinus anatomy classification (IFAC) and classification of the extent of endoscopic frontal sinus surgery (EFSS). Int Forum Allergy Rhinol. 2016;6(7):677–96. Quatre R, Attye A, Righini CA, Reyt E, Giai J, Schmerber S, et al. Spontaneous cerebrospinal fluid rhinorrhea: association with body weight and imaging data. J Neurol Surg B Skull Base. 2017;78(5):419–24. Lai SY, Kennedy DW, Bolger WE. Sphenoid encephaloceles: disease management and identification of lesions within the lateral recess of the sphenoid sinus. Laryngoscope. 2002;112(10):1800–5. Scott KW, Tavanaiepour D, Tavanaiepour K, Halawi A, Rao D, Rahmathulla G. Spontaneous cerebral spinal fluid rhinorrhea with meningocele secondary to congenital foramen rotundum defect: a case report and review of literature. Asian J Neurosurg. 2020;15(1):187–9. Psaltis AJ, Overton LJ, Thomas WW3rd, Fox NF, Banks CA, Schlosser RJ. Differences in skull base thickness in patients with spontaneous cerebrospinal fluid leaks. Am J Rhinol Allergy. 2014;28(1):e73–9. Harley B, Wickremesekera A, Tan N, Davies E, Robinson S, Baguley C, et al. Endoscopic transnasal repair of two cases of spontaneous cerebrospinal fluid fistula in the foramen rotundum. J Clin Neurosci. 2019;59:350–2. Illing E, Schlosser RJ, Palmer JN, Curé J, Fox N, Woodworth BA. Spontaneous sphenoid lateral recess cerebrospinal fluid leaks arise from intracranial hypertension, not Sternberg’s canal. Int Forum Allergy Rhinol. 2014;4(3):246–50. Article / Publication Details

Received: June 04, 2022
Accepted: February 17, 2023
Published online: April 19, 2023

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 4

ISSN: 0301-1569 (Print)
eISSN: 1423-0275 (Online)

For additional information: https://www.karger.com/ORL

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.