An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 10 , ISSUE 1 ( January-April, 2018 ) > List of Articles

ORIGINAL ARTICLE

Computed Tomography Cisternography for the Management of Cerebrospinal Fluid Fistulae

Mukund D Rahalkar, Anand M Rahalkar, Vardhan S Joshi, Kailash V Sant, Kourabhi B Zade

Keywords : Cerebrospinal fluid fistula, Cerebrospinal fluid leak, Computed tomography cisternography, Cribriform plate, Functional endoscopic sinus surgery for rhinorrhea, Management of cerebrospinal fluid fistulae.

Citation Information : Rahalkar MD, Rahalkar AM, Joshi VS, Sant KV, Zade KB. Computed Tomography Cisternography for the Management of Cerebrospinal Fluid Fistulae. Int J Otorhinolaryngol Clin 2018; 10 (1):17-27.

DOI: 10.5005/jp-journals-10003-1283

License: CC BY-NC 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Cerebrospinal fluid (CSF) fistula is an increasingly common condition these days with traumatic cause being commoner than either surgical or nonsurgical trauma. The patient usually presents either with rhinorrhea or less frequently otorrhea. Computed tomography (CT) cisternography is widely used in the diagnostic workup of such patients. It helps to localize the site of leak and to establish the underlying cause. The purpose of this article is to present an overview of CT cisternography findings in various types of CSF fistula, i.e., rhinorrhea, otorrhea, and otorhinorrhea and the management based on them. Magnetic resonance cisternography was not utilized as the CT provides bony detail much better, which is useful for the operating surgeon or endoscopist.


PDF Share
  1. Lloyd KM, DelGaudio JM, Hudgins PA. Imaging of skull base cerebrospinal fluid leaks in adults. Radiology 2008 Sep;248(3):725-736.
  2. Lund VJ, Savy L, Lloyd G, Howard D. Optimum imaging and diagnosis of cerebrospinal fluid rhinorrhoea. J Laryngol Otol 2000 Dec;114(12):988-992.
  3. Ommaya AK, Di Chiro G, Baldwin M, Pennybacker JB. Non-traumatic cerebrospinal fluid rhinorrhoea. J Neurol Neurosurg Psychiat 1968 Jun;31(3):214-225.
  4. Yerkes SA, Thompson DH, Fisher WS 3rd. Spontaneous cerebrospinal fluid rhinorrhea. Ear Nose Throat J 1992 Jul;71(7):318-320.
  5. Nirmal Kumar K, Thiagarajan B. Cerebrospinal fluid rhinorrhoea an overview. WebmedCentral Otorhinolaryngology 2012 May;3(5):WMC003382.
  6. Bendersky DC, Landriel FA, Ajler PM, Hem SM, Carrizo AG. Sternberg's canal as a cause of encephalocoele within the lateral recess of the sphenoid sinus: a report of two cases. Surg Neurol Int 2011 Nov;2:171.
  7. Stone JA, Castillo M, Neelon B, Mukherji SK. Evaluation of CSF leaks: high-resolution CT compared with contrastenhanced CT and radionuclide cisternography. AJNR Am J Neuroradiol 1999 Apr;20(4):706-712.
  8. Petrus LV, Lo WW. Spontaneous CSF otorrhoea caused by abnormal development of the facial nerve canal. AJNR Am J Neuroradiol 1999 Feb;20(2):275-277.
  9. Sannareddy RR, Rambabu K, Kumar VE, Gnana RB, Ranjan A. Endoscopic management of CSF rhinorrhoea. Neurol India 2014 Sep-Oct;62(5):532-539.
  10. Allen F, Riopelle J, Sinha A. Intracranial placement of a nasotracheal tube in a patient with Goldenhar syndrome associated with cribriform plate agenesis. Anesth Analg 2011 Jan;112(1):198-200.
  11. Singh M, Jain V, Gupta SC, Singh SP. Intranasal endoscopic DCR (END-DCR) in cases of dacryocystitis. Indian J Otolaryngol Head Neck Surg 2004 Jul;56(3):177-183.
  12. Yung MW, Hardman-Lea S. Endoscopic interior dacryocystorhinostomy. Clin Otolaryngol Allied Sci 1998 Apr;23(2):152-157.
  13. Kakkar V, Chugh JP, Sachdeva S, Sharma N. Endoscopic dacryocystorhinostomy with and without silicone stent: a comparative study. Int J Otorhinolaryngol 2009;9:1.
  14. Wormald PJ. Powered endonasal dacryocystorhinostomy. Laryngoscope 2002 Jan;112(1):69-72.
  15. Mann BS, Wormald PJ. Endoscopic assessment of the dacryocystorhinostomy ostium after endoscopic surgery. Laryngoscope 2006 Jul;116(7):1172-1174.
  16. Cokkeser Y, Evereklioglu C, Er H. Comparative external versus endoscopic dacryocystorhinostomy: results in 115 patients (130 eyes). Otolaryngol Head Neck Surg 2000 Oct;123(4):488-491.
  17. Fayet B, Racy E, Assouline M. Systematic unciformectomy for a standardized endonasal dacryocystorhinostomy. Ophthalmology 2002 Mar;109(3):530-536.
  18. Unlu HH, Toprak B, Aslan A, Guler C. Comparison of surgical outcomes in primary endoscopic dacryocystorhinostomy with and without silicon intubation. Ann Otol Rhinol Laryngol 2002 Aug;111(8):704-709.
  19. Atighechi S, Baradaranfar MH, Karimi G, Jafari R. Antrochoanal polyp: a comparative study of endoscopic endonasal surgery alone and endoscopic endonasal plus mini-Caldwell technique. Eur Arch Otorhinolaryngol 2009 Aug;266(8):1245-1248.
  20. Lee TJ, Huang SF. Endoscopic sinus surgery for antrochoanal polyps in children. Otolaryngol Head Neck Surg 2006 Nov;135(5):688-692.
  21. Mantovani K, Bisanha AA, Demarco RC, Tamashiro E, Martinez R, Anselmo-Lima WT. Maxillary sinuses microbiology from patients with chronic rhinosinusitis. Braz J Otorhinolaryngol 2010 Sep-Oct;76(5):548-551.
  22. Brook I, Gober AE. Recovery of potential pathogens in the nasopharynx of healthy and otitis media-prone children and their smoking and nonsmoking parents. Ann Otol Rhinol Laryngol 2008 Oct;117(10):727-730.
  23. Wu J, Peters BA, Dominianni C, Zhang Y, Pei Z, Yang L, Ma Y, Purdue MP, Jacobs EJ, Gapstur SM, et al. Cigarette smoking and the oral microbiome in a large study of American adults. ISME J 2016 Mar;10(10):2435-2446.
  24. Ertel A, Eng R, Smith SM. The differential effect of cigarette smoke on the growth of bacteria found in humans. Chest 1991 Sep;100(3):628-630.
  25. Reh DD, Higgins TS, Smith TL. Impact of tobacco smoke on chronic rhinosinusitis: a review of the literature. Int Forum Allergy Rhinol 2012 Sep-Oct;2(5):362-369.
  26. Lee KI, Kim DW, Kim EH, Kim JH, Samivel R, Kwon JE, Ahn JC, Chung YJ, Mo JH. Cigarette smoke promotes eosinophilic inflammation, airway remodeling, and nasal polyps in a murine polyp model. Am J Rhinol Allergy 2014 May-Jun;28(3):208-214.
  27. Kumar PS, Matthews CR, Joshi V, de Jager M, Aspiras M. Tobacco smoking affects bacterial acquisition and colonization in oral biofilms. Infect Immun 2011 Nov;79(11): 4730-4738.
  28. Namiot Z, Namiot DB, Kemona A, Gołebiewska M, Bucki R. The effect of cigarette smoking and alcohol consumption on efficacy of Helicobacter pylori eradication. Pol Arch Med Wewn 2000 Sep;104(3):569-574.
  29. Linder JA, Sim I. Antibiotic treatment of acute bronchitis in smokers: a systematic review. J Gen Intern Med 2002 Mar;17(3):230-234.
  30. Lee WK, Ramanathan M Jr, Spannhake EW, Lane AP. The cigarette smoke component acrolein inhibits expression of the innate immune components IL-8 and human betadefensin 2 by sinonasal epithelial cells. Am J Rhinol 2007 Nov-Dec;21(6):658-663.
  31. Kamath PM, Shenoy VS, Mittal N, Sharma NK. Microbiological analysis of paranasal sinuses in chronic sinusitis—a south Indian coastal study. Egypt J Ear Nose Throat All Sci 2013 Nov;14(3):185-189.
  32. Bezerra TF, Pádna FG, Ogawa AI, Gebrim EM, Saldiva PH, Voegels RL. Biofilms in chronic rhinosinusitis with nasal polyps: pilot study. Braz J Otorhinolaryngol 2009 Nov- Dec;75(6):788-793.
  33. Hashemi M, Sadeghi MMM, Omrani MR, Torabi MA. Microbiology and antimicrobial resistance in chronic resistant rhino sinusitis with or without polyp after functional endoscopic sinus surgery. J Res Med Sci 2005;10(3):167-171.
  34. Farahani F, Youse Mashouf R, Hashemian F, Esmaeili R. Antimicrobial resistance patterns of aerobic organisms in patients with chronic rhinosinusitis in Hamadan, Iran. Avicenna J Clin Microb Infec 2014 Aug;1(2):e18961..
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.