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Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery

Objectives Pseudo-cerebrospinal fluid (CSF) rhinorrhea is a rare phenomenon, presumed to result from aberrant autonomic reinnervation of the paranasal mucosa following injury to the greater superficial petrosal nerve or periarterial plexus. In this report, we discuss the case of a postoperative pati...

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Autores principales: Grannan, Benjamin L., Linda Bi, Wenya, Dunn, Ian F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520968/
https://www.ncbi.nlm.nih.gov/pubmed/26251813
http://dx.doi.org/10.1055/s-0034-1396655
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author Grannan, Benjamin L.
Linda Bi, Wenya
Dunn, Ian F.
author_facet Grannan, Benjamin L.
Linda Bi, Wenya
Dunn, Ian F.
author_sort Grannan, Benjamin L.
collection PubMed
description Objectives Pseudo-cerebrospinal fluid (CSF) rhinorrhea is a rare phenomenon, presumed to result from aberrant autonomic reinnervation of the paranasal mucosa following injury to the greater superficial petrosal nerve or periarterial plexus. In this report, we discuss the case of a postoperative patient with pseudo-CSF rhinorrhea exacerbated by chewing and propose a novel mechanism of pseudo-CSF rhinorrhea. Case Report A 46-year-old man was found to have mastication-induced unilateral clear rhinorrhea following transtemporal resection of a cerebellopontine angle tumor. Computed tomography cisternogram and β-2 transferrin analysis proved negative for any evidence of CSF leak. Conclusions Pseudo-CSF rhinorrhea exacerbated by mastication has not been previously reported in the literature. We propose aberrant cross-innervation of the trigeminal and facial nerves as the mechanism underlying the patient's condition. Pseudo-CSF rhinorrhea is an important entity to identify following skull base surgery because it may spare patients from the unnecessary invasive procedures and morbidity associated with the management of a presumed CSF leak.
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spelling pubmed-45209682015-08-06 Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery Grannan, Benjamin L. Linda Bi, Wenya Dunn, Ian F. J Neurol Surg Rep Article Objectives Pseudo-cerebrospinal fluid (CSF) rhinorrhea is a rare phenomenon, presumed to result from aberrant autonomic reinnervation of the paranasal mucosa following injury to the greater superficial petrosal nerve or periarterial plexus. In this report, we discuss the case of a postoperative patient with pseudo-CSF rhinorrhea exacerbated by chewing and propose a novel mechanism of pseudo-CSF rhinorrhea. Case Report A 46-year-old man was found to have mastication-induced unilateral clear rhinorrhea following transtemporal resection of a cerebellopontine angle tumor. Computed tomography cisternogram and β-2 transferrin analysis proved negative for any evidence of CSF leak. Conclusions Pseudo-CSF rhinorrhea exacerbated by mastication has not been previously reported in the literature. We propose aberrant cross-innervation of the trigeminal and facial nerves as the mechanism underlying the patient's condition. Pseudo-CSF rhinorrhea is an important entity to identify following skull base surgery because it may spare patients from the unnecessary invasive procedures and morbidity associated with the management of a presumed CSF leak. Georg Thieme Verlag KG 2015-01-16 2015-07 /pmc/articles/PMC4520968/ /pubmed/26251813 http://dx.doi.org/10.1055/s-0034-1396655 Text en © Thieme Medical Publishers
spellingShingle Article
Grannan, Benjamin L.
Linda Bi, Wenya
Dunn, Ian F.
Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery
title Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery
title_full Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery
title_fullStr Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery
title_full_unstemmed Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery
title_short Pseudo-Cerebrospinal Fluid Rhinorrhea Resulting from Aberrant Cross-Innervation of Trigeminal and Facial Nerves following Skull Base Surgery
title_sort pseudo-cerebrospinal fluid rhinorrhea resulting from aberrant cross-innervation of trigeminal and facial nerves following skull base surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520968/
https://www.ncbi.nlm.nih.gov/pubmed/26251813
http://dx.doi.org/10.1055/s-0034-1396655
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