This condition is characterised by the flow of cerebro-spinal fluid
from the nose or clearing backwards from the nose into the throat.
This is a very rare condition when spontaneous, however it can be
seen in the presence of trauma to the skull or following skull base
Traumatic: from fractures to the skull base including the
area adjacent to the nasal cavity, whereby tearing of the linings of the
brain allow cerebro-spinal fluid to leak into the nose.
Spontaneous: arising from a congenital defect within the area
adjacent to the nose and brain, allowing leakage of the CSF into the
nose, or due to destructive lesions and tumours in this area eroding
into the bony partition in between the nose and brain.
Watery fluid arising from the right or left side of the nose, frequently noted when bending forwards.
Complications of the Disorder
Meningitis. Indeed this condition may be the presenting symptom for CSF rhinorrhoea.
The fluid arising from the nose can be tested for a particular
protein, thus proving the origin for the fluid to be from the
cerebro-spinal fluid. Scans including MRI scanning and CT scanning may
be required to identify the precise area of leakage for the CSF. This
may also involve inserting fluorescein or a similar dye to the CSF space
using a lumbar puncture then observing the leakage within the nose.
Depending upon the site of origin of the leak and the possible access
to the area, the repair may involve an endoscopic approach through the
nose and sinuses or a formal craniotomy to open the skull to retract the
brain and apply the graft material to the leaking site.
If treated successfully, then the leak will stop. However, this can
occasionally be difficult and the leak could persist and require further
repair. If un-repaired, the prospect for meningitis occurring remains a
Mr D Skinner FRCS