A clinical study of spontaneous CSF rhinorrhoea.

A retrospective study of 10 patients presenting with spontaneous (normal pressure) CSF rhinorrhoea was performed. The epidemiology, role of radiology and surgical treatment are discussed. Nose blowing was found to cause onset of rhinorrhoea in 30% of patients studied. The presence of congenital dehiscences and the formation of small meningoceles are the most likely aetiological basis for this condition. The Valsalva like effect of nose blowing may cause dural rupture at sites of dehiscence thereby leading to rhinorrhoea. Contrast CT imaging identified the site of leakage in 70% of cases and further identified the side of leak in 20%. Contrast CT imaging is, therefore, the best modality for investigating these patients. Extracranial methods successfully repaired 88% of leaks compared with 50% for craniotomy. Extracranial techniques should be the primary surgical option since they have higher rates of successful repair and less morbidity than craniotomy.