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  • Title: Management of a pediatric patient with spontaneous cerebrospinal fluid leak in the lateral recess of sphenoid sinus and meningoencephalocele: A case report and literature review.
    Author: AlKandery M, AlSaidan L, Owayed F, AlQunaee M, Al-Sihan M, Alterki A.
    Journal: Int J Surg Case Rep; 2023 Sep; 110():108727. PubMed ID: 37659158.
    Abstract:
    INTRODUCTION AND IMPORTANCE: Spontaneous cerebrospinal fluid (CSF) leak in the lateral recess of the sphenoid (LRS) sinus in a pediatric population is rare and is surgically challenging to repair. CASE PRESENTATION: We report a case of a 13-year-old girl with hydrocephalus and a ventriculoperitoneal shunt who presented with a two-month history of clear rhinorrhea from the right nostril. Computed tomography (CT) of the head was performed and showed CSF leak through a defect in the lateral recess of the sphenoid sinus. Defect closure was achieved using an endoscopic endonasal approach. CLINICAL DISCUSSION: CSF leak with meningoencephalocele from the sphenoid sinus is amongst the most difficult cases for repair. Yet the successful rate of repair is as high as 90 % if done endoscopically. Moreover, the location of the defect determines the surgical approach. CONCLUSION: Spontaneous CSF rhinorrhea from the lateral recess of the sphenoid (LRS) sinus, although rare, requires prompt diagnosis and treatment, as it may lead to significant mortality and morbidity.
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