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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(04): 379-383
DOI: 10.5999/aps.2017.00913
Case Report

Traumatic cerebrospinal fluid leakage following septorhinoplasty

Ahmed Youssef
Department of Otolaryngology-Head and Neck Surgery, University Hospital Birmingham, Birmingham, UK
Department of Otolaryngology-Head and Neck Surgery, Alexandria University, Alexandria, Egypt
,
Shahzad Ahmed
Department of Otolaryngology-Head and Neck Surgery, University Hospital Birmingham, Birmingham, UK
,
Ahmed Aly Ibrahim
Department of Otolaryngology-Head and Neck Surgery, Alexandria University, Alexandria, Egypt
,
Mulvihill Daniel
Department of Otolaryngology-Head and Neck Surgery, University Hospital Birmingham, Birmingham, UK
,
Hisham M. Abdelfattah
Department of Otolaryngology-Head and Neck Surgery, Alexandria University, Alexandria, Egypt
,
Haitham Morsi
Department of Otolaryngology-Head and Neck Surgery, Alexandria University, Alexandria, Egypt
› Author AffiliationsThe article was presented in ALEXORL combined congress meeting April 2016(Alexandria, Egypt) and regional West Midland meeting October 2016 (Birmingham, UK). The Abstract is submitted for oral/poster presentation in AAO_HNSF on September 8-10, 2017, in Chicago, IL, USA.
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Septoplasty/septorhinoplasty is a common ear, nose and throat procedure offered for those patients with deviated septum who are suffering from nasal obstruction and functional or cosmetic problems. Although it is a basic and simple procedure, it could lead to catastrophic complications including major skull base injuries which result in cerebrospinal fluid (CSF) leaks. We describe two different cases of traumatic CSF leaks following septoplasty/septorhinoplasty at two different sites. The first patient suffered a CSF leak following septoplasty and presented to Alexandria University Hospital. The leak was still active at presentation and identified as coming from a defect in the roof of the sphenoid sinus and was repaired surgically. The second patient presented 4 days after her cosmetic septorhinoplasty with a CSF leak and significant pneumocephalus. She was managed conservatively. Understanding the anatomical variations of the paranasal sinuses and implementing proper surgical techniques are crucial in preventing intracranial complications when performing either septoplasty or septorhinoplasty. A good quality computed tomography of the nose and paranasal sinuses is a valuable investigation to avoid major complications especially CSF leaks following either procedure.

Keywords

Rhinoplasty - Cerebrospinal fluid rhinorrhea - Sphenoid sinus - Computed tomography - Diabetes insipidus


Publication History

Received: 28 May 2017

Accepted: 18 October 2017

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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