Cerebrospinal fluid (CSF) is a liquid contained within the lining around the brain, called the dura. When there is a hole in the dura and bone, separating the brain from the sinuses, CSF can leak into the sinuses. This can cause clear, water-like fluid drainage from the nose or into the back of the throat. If the CSF drains out of the nose, it is usually from one side. If it drains into the throat, it has been described as salty tasting.
A break in the bone and dura can occur due to:
- An accident involving the head
- A complication from sinus or brain surgery
- An expected consequence of removing a tumor within the sinuses
- Anything else that can increase pressures on the brain
Tests
Imaging
If a CSF leak is suspected, your ENT specialist will likely order a computerized tomography (CT) or magnetic resonance imaging (MRI) scan of your sinus to make an accurate diagnosis and determine the site of the leak.
Fluid Testing
You may be asked to collect some of the fluid for special testing to confirm it is CSF.
Nasal Endoscopy
You may be scheduled for nasal endoscopy after injection of a green dye into the CSF, through a lumbar drain. This further pinpoints the site of the leak and assists in the repair.
Treatments
Lumbar Drain
A lumbar drain is a small tubing placed in the lower back that allows drainage of small amounts of cerebrospinal fluid (CSF) for a limited period of time. This will be performed in the hospital setting. This drain reduces pressure from the constant flow of CSF through any injured areas so they can heal. Over 90 percent of traumatic CSF leaks will heal with this treatment – or with only observation – and you will not require surgery. However, if the CSF leak is due to other causes, you likely will require surgery to prevent serious potential complications like meningitis or brain abscess.
CSF Leak Repair
In more extreme cases of a CSF leak, you may need surgery to repair the hole. This surgery is performed through the nasal cavity using a small scope called a nasal endoscope to view the defect and repair the leak. You may need to stay overnight in the hospital one night, or you may return home the same day of surgery.
Why Choose UHealth?
Ranked in the nation’s top tier by U.S. News & World Report. The ranking reflects the team’s dedication to excellence in research patient care and outcomes. Surgeons, audiologists, biomedical engineers, speech pathologists, researchers, and psychologists collaborate with many research programs at the University of Miami Miller School of Medicine to deliver the best possible multidisciplinary care to pediatric and adult ear, nose, and throat patients.
Highly specialized rhinology doctors. The experts at University of Miami Health are here to help you breathe easier, smell better, and rest better with an accurate diagnosis and leading edge treatments in a compassionate setting. Our fellowship-trained providers specialize in the nasal airway, and our rhinology specialists have completed specialized training in nasal and sinus disorders. They have dedicated their clinical and research careers to caring for nasal and sinus disorders.
Our academic health center provides you with more treatment options. Our ENT specialists are experts in the field of rhinology. As part of an academic health center, we are proud to offer breakthrough treatments not available to other facilities in South Florida. We also offer our patients early access to clinical trials and new medical and procedural treatments. We provide comprehensive care for a wide array of rhinologic conditions, backed by expertise, research, and education.
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