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Empty sellalı bir olguda spontan serebrospinal rinore: Fistülün transnazal transsfenoidal onarımı

Year 2003, Volume: 10 Issue: 3, 110 - 113, 01.06.2003

Harun Cansız Ender İnci Nihat Şekercioğlu

Abstract

Spontan serebrospinal rinore nadir görülen bir du- rumdur; daha sıklıkla serabral tümörlere veya hid- rosefalusa bağlı olarak geliflir. Empty sella sendro- mu ile birlikte görülmesi daha da nadirdir. Sol na- zal akıntı flikayetiyle baflvuran 63 yaflındaki kadın hasta, serebrospinal sıvı rinoresi öntanısı ile yatı- rıldı. Nazal sıvı incelendiğinde renksiz olduğu gö- rüldü; Pandy testi pozitif, glukoz %72 düzeyinde bulundu. Manyetik rezonans görüntülemede sup- rasellar sisternanın sellar kaviteye herniye olduğu ve sfenoid sinüsün orta derecede kontrast tuttuğu izlendi. Fistülün onarımı transnazal ve transsfeno- idal yolla gerçeklefltirildi. Hastanın befl yıllık takibi süresince herhangi bir semptom ya da nüksle kar- fl ı l a fl ı l m a d ı

Keywords

Beyin omurilik sıvısı rinoresi/komplikasyon/cerrahi fistül/komplikasyon/cerrahi manyetik rezonans görüntüleme sella turcica sfenoid sinüs/cerrahi subaraknoid boflluk

References

  • B rockbank MJ, Veitch DY, Thomson HG. Cere b ro s p i n a l fluid in the rhinitis clinic. J Laryngol Otol 1989;103:281-3.
  • Tolley NS, Lloyd GA, Williams HO. Radiological study of primary spontaneous CSF rhinorrhoea. J Laryngol Otol 1991;105:274-7.
  • Garcia-Uria J, Carrillo R, Serrano P, Bravo G. Empty sella and rhinorrhea. A report of eight treated cases. J Neurosurg 1979;50:466-71.
  • Weiss MH, Kaufman B, Richards DE. Cerebrospinal fluid rhinorrhea from an empty sella: transsphenoidal obliteration of the fistula. Technical note. J Neurosurg 1973;39:674-6.
  • Bleach NR, Stanworth PA, Stansbie JM. Spontaneous cerebrospinal fluid rhinorrhoea (an investigative prob- lem). J Laryngol Otol 1988;102:633-5.
  • Ommaya AK. Spinal fluid fistulae. Clin Neurosurg 1976;23:363-92.
  • Loew F, Pertuiset B, Chaumier ET. Traumatic, sponta- neous and postoperative CSF rhinorrhea. In: Symon L, Brihaye J, editors. Advances and technical standarts in neurosurgery. 1st ed. New York: Springer; 1984. p. 169- 207.
  • Calcaterra TC. Extracranial surgical repair of cere- b rospinal rh i n o r rhea. Ann Otol Rhinol Laryngol 1980; 89(2 Pt 1):108-16.
  • Jordan RM, Kendall JW, Kerber CW. The primary empty sella syndrome: analysis of the clinical charac- teristics, radiographic features, pituitary function and cerebrospinal fluid adenohypophysial hormone con- centrations. Am J Med 1977;62:569-80.
  • Mortara R, Norrell H. Consequences of a deficient sel- lar diaphragm. J Neurosurg 1970;32:565-73.
  • Briant TD, Bird R. Extracranial repair of cerebrospinal fluid fistulae. J Otolaryngol 1982;11:191-7.
  • Park JI, Strelzow VV, Friedman WH. Current manage- ment of cerebrospinal fluid rhinorrhea. Laryngoscope 1983;93:1294-300.
  • Chandler JR. Traumatic cerebrospinal fluid leakage. Otolaryngol Clin North Am 1983;16:623-32.
  • Persky MS, Rothstein SG, Breda SD, Cohen NL, Cooper P, Ransohoff J. Extracranial repair of cere b rospinal fluid o t o rh i n o r rhea. Laryngoscope 1991;101:134-6.
  • Marshall AH, Jones NS, Robertson IJ. CSF rhinorrhoea: the place of endoscopic sinus surgery. Br J Neurosurg 2001;15:8-12.
  • Daniilidis J, Vlachtsis K, Ferekidis E, Dimitriadis A. Intrasphenoidal encephalocele and spontaneous CSF rhinorrhoea. Rhinology 1999;37:186-9.

Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula

Year 2003, Volume: 10 Issue: 3, 110 - 113, 01.06.2003

Harun Cansız Ender İnci Nihat Şekercioğlu

Abstract

Spontaneous cerebrospinal rhinorrhea is a rare clinical condition. More commonly it develops due to cerebral tumours or hydrocephalus; it is seldom seen in association with empty sella syndrome. A sixty-three-year- old woman who presented with left nasal discharge was hospitalized on the suspicion of CSF rhinorrhea.Analysis of the nasal fluid revealed a clear colour, a positive Pandy’s test, and a positive result for glucose 72% . On magnetic resonance seans, herniation of the suprasellar cistern was observed into the sellar cavity, and the left sphenoid sinüs was filled with contrast medium. The repair of the fistula was performed via a transnasal and transsphenoidal approach. The patient was followed-up for five years without any symptoms or recurrences.

Keywords

Cerebrospinal fluid rhinorrhea/complications/ surgery fistula/complications/surgery magnetic resonance imaging sellaturcica sphenoid sinus/surgery subarachnoid space

References

  • B rockbank MJ, Veitch DY, Thomson HG. Cere b ro s p i n a l fluid in the rhinitis clinic. J Laryngol Otol 1989;103:281-3.
  • Tolley NS, Lloyd GA, Williams HO. Radiological study of primary spontaneous CSF rhinorrhoea. J Laryngol Otol 1991;105:274-7.
  • Garcia-Uria J, Carrillo R, Serrano P, Bravo G. Empty sella and rhinorrhea. A report of eight treated cases. J Neurosurg 1979;50:466-71.
  • Weiss MH, Kaufman B, Richards DE. Cerebrospinal fluid rhinorrhea from an empty sella: transsphenoidal obliteration of the fistula. Technical note. J Neurosurg 1973;39:674-6.
  • Bleach NR, Stanworth PA, Stansbie JM. Spontaneous cerebrospinal fluid rhinorrhoea (an investigative prob- lem). J Laryngol Otol 1988;102:633-5.
  • Ommaya AK. Spinal fluid fistulae. Clin Neurosurg 1976;23:363-92.
  • Loew F, Pertuiset B, Chaumier ET. Traumatic, sponta- neous and postoperative CSF rhinorrhea. In: Symon L, Brihaye J, editors. Advances and technical standarts in neurosurgery. 1st ed. New York: Springer; 1984. p. 169- 207.
  • Calcaterra TC. Extracranial surgical repair of cere- b rospinal rh i n o r rhea. Ann Otol Rhinol Laryngol 1980; 89(2 Pt 1):108-16.
  • Jordan RM, Kendall JW, Kerber CW. The primary empty sella syndrome: analysis of the clinical charac- teristics, radiographic features, pituitary function and cerebrospinal fluid adenohypophysial hormone con- centrations. Am J Med 1977;62:569-80.
  • Mortara R, Norrell H. Consequences of a deficient sel- lar diaphragm. J Neurosurg 1970;32:565-73.
  • Briant TD, Bird R. Extracranial repair of cerebrospinal fluid fistulae. J Otolaryngol 1982;11:191-7.
  • Park JI, Strelzow VV, Friedman WH. Current manage- ment of cerebrospinal fluid rhinorrhea. Laryngoscope 1983;93:1294-300.
  • Chandler JR. Traumatic cerebrospinal fluid leakage. Otolaryngol Clin North Am 1983;16:623-32.
  • Persky MS, Rothstein SG, Breda SD, Cohen NL, Cooper P, Ransohoff J. Extracranial repair of cere b rospinal fluid o t o rh i n o r rhea. Laryngoscope 1991;101:134-6.
  • Marshall AH, Jones NS, Robertson IJ. CSF rhinorrhoea: the place of endoscopic sinus surgery. Br J Neurosurg 2001;15:8-12.
  • Daniilidis J, Vlachtsis K, Ferekidis E, Dimitriadis A. Intrasphenoidal encephalocele and spontaneous CSF rhinorrhoea. Rhinology 1999;37:186-9.
There are 16 citations in total.

Details

Primary Language English
Journal Section Case Report
Authors

Harun Cansız This is me

Ender İnci This is me

Nihat Şekercioğlu This is me

Publication Date June 1, 2003
Published in Issue Year 2003 Volume: 10 Issue: 3

Cite

APA Cansız, H., İnci, E., & Şekercioğlu, N. (2003). Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula. The Turkish Journal of Ear Nose and Throat, 10(3), 110-113.
AMA Cansız H, İnci E, Şekercioğlu N. Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula. Tr-ENT. June 2003;10(3):110-113.
Chicago Cansız, Harun, Ender İnci, and Nihat Şekercioğlu. “Spontaneous Cerebrospinal Fluid Rhinorrhea Associated With Empty Sella: A Transnasal-Transsphenoidal Repair of the Fistula”. The Turkish Journal of Ear Nose and Throat 10, no. 3 (June 2003): 110-13.
EndNote Cansız H, İnci E, Şekercioğlu N (June 1, 2003) Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula. The Turkish Journal of Ear Nose and Throat 10 3 110–113.
IEEE H. Cansız, E. İnci, and N. Şekercioğlu, “Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula”, Tr-ENT, vol. 10, no. 3, pp. 110–113, 2003.
ISNAD Cansız, Harun et al. “Spontaneous Cerebrospinal Fluid Rhinorrhea Associated With Empty Sella: A Transnasal-Transsphenoidal Repair of the Fistula”. The Turkish Journal of Ear Nose and Throat 10/3 (June 2003), 110-113.
JAMA Cansız H, İnci E, Şekercioğlu N. Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula. Tr-ENT. 2003;10:110–113.
MLA Cansız, Harun et al. “Spontaneous Cerebrospinal Fluid Rhinorrhea Associated With Empty Sella: A Transnasal-Transsphenoidal Repair of the Fistula”. The Turkish Journal of Ear Nose and Throat, vol. 10, no. 3, 2003, pp. 110-3.
Vancouver Cansız H, İnci E, Şekercioğlu N. Spontaneous cerebrospinal fluid rhinorrhea associated with empty sella: a transnasal-transsphenoidal repair of the fistula. Tr-ENT. 2003;10(3):110-3.