A unique case of bilateral recurrent sphenoid sinus cerebrospinal fluid leaks: Primary acquired leak within the lateral sphenoid sinus recess, followed by a leak via Sternberg's canal

Alexander P. Marston, Jamie Van Gompel, Matthew L. Carlson, Erin K. O'Brien

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: This case presents a previously undescribed clinical scenario of spontaneous cerebrospinal fluid (CSF) leaks secondary to a lateral sphenoid sinus recess skull base dehiscence and contralateral Sternberg's canal. This case report aims to characterize the presentation and successful management of these lesions. Methods: The electronic medical record was used to collect information pertaining to the patient's clinical history. Results: The patient was a middle-aged, obese female with persistent clear rhinorrhea as her only presenting symptom. Neuroradiologic studies localized the defect to the lateral sphenoid sinus recess. CSF opening pressures were within normal limits, but radiographic findings were consistent with elevated intracranial pressure. After an endoscopic transnasal transsphenoidal approach failed to resolve the CSF leak, a transpterygoid approach facilitated CSF leak resolution. The patient then did well for the following 2 years, but later developed a CSF leak through a contralateral Sternberg's canal. An endoscopic suprapterygoid procedure and ventriculoperitoneal shunt placement led to CSF leak resolution. Conclusion: This case demonstrates one of the only published examples of a sphenoid sinus CSF leak secondary to Sternberg's canal as it was originally described in the literature. Wide endoscopic surgical exposure and intracranial pressure management ultimately led to CSF leak resolution.

Original languageEnglish (US)
Pages (from-to)593-597
Number of pages5
JournalAnnals of Otology, Rhinology and Laryngology
Volume124
Issue number8
DOIs
StatePublished - Jan 1 2015

Fingerprint

Transverse Sinuses
Sphenoid Sinus
Cerebrospinal Fluid Pressure
Ventriculoperitoneal Shunt
Intracranial Hypertension
Electronic Health Records
Skull Base
Intracranial Pressure
Cerebrospinal Fluid Leak

Keywords

  • Idiopathic intracranial hypertension
  • Lateral sphenoid sinus recess
  • Spontaneous cerebrospinal fluid leak
  • Sternberg's canal
  • Transpterygoid

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

Cite this

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title = "A unique case of bilateral recurrent sphenoid sinus cerebrospinal fluid leaks: Primary acquired leak within the lateral sphenoid sinus recess, followed by a leak via Sternberg's canal",
abstract = "Objectives: This case presents a previously undescribed clinical scenario of spontaneous cerebrospinal fluid (CSF) leaks secondary to a lateral sphenoid sinus recess skull base dehiscence and contralateral Sternberg's canal. This case report aims to characterize the presentation and successful management of these lesions. Methods: The electronic medical record was used to collect information pertaining to the patient's clinical history. Results: The patient was a middle-aged, obese female with persistent clear rhinorrhea as her only presenting symptom. Neuroradiologic studies localized the defect to the lateral sphenoid sinus recess. CSF opening pressures were within normal limits, but radiographic findings were consistent with elevated intracranial pressure. After an endoscopic transnasal transsphenoidal approach failed to resolve the CSF leak, a transpterygoid approach facilitated CSF leak resolution. The patient then did well for the following 2 years, but later developed a CSF leak through a contralateral Sternberg's canal. An endoscopic suprapterygoid procedure and ventriculoperitoneal shunt placement led to CSF leak resolution. Conclusion: This case demonstrates one of the only published examples of a sphenoid sinus CSF leak secondary to Sternberg's canal as it was originally described in the literature. Wide endoscopic surgical exposure and intracranial pressure management ultimately led to CSF leak resolution.",
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AU - Carlson, Matthew L.

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