CSF rhinorrhea is most commonly seen in fracture of
CSF rhinorrhea occurs when there is a communication between the intracranial (intradural) and nasal cavities. CSF, rhinorrhea indicates a basal tear of dura mater along with a fracture involving the paranasal sinuses, frontal, ethmoid, or sphenoid bone. Cribriform plate of the ethmoid bone separates the anterior cranial fossa from the nasal cavity and is the most common site of fracture in CSF rhinorrhea because it is extremely thin. The cerebrospinal fluid has high glucose content, makes a dry hanky stiff, and if mixed with blood it classically produces a halo effect on the white bedclothes. Patients of CSF rhinorrhea are at increased risk of meningitis paicularly pneumococcal. The patient should be given prophylactic antibiotic (penicillin) followed by X-ray. Fractures of the middle 1/3rd of the face should be reduced and most of the times CSF rhinorrhea stops. Indications for anterior fossa explorations are the persistence of CSF rhinorrhea for> 10 days; the presence of a fracture involving the frontal or ethmoidal sinus; aerocele; an attack of meningitis that has been treated. Ref : Diseases of ENT by Dhingra 6th edition Pgno : 163-165
Cribriform plate
Temporal bone
Nasal bone
Occipital bone
Nose and paranasal sinuses