PSEUDO-CEREBROSPINAL FLUID RHINORRHEA

Because of its potentially serious sequelae, cerebrospinal fluid (CSF) leakage following surgery for lesions of the cranial base is given im mediate attention by neurosurgeons. Despite a multitude of approaches used to prevent its occurrence, CSF leakage complicates up to 30% of d ifficult skull-base tumor operations. The authors describe the cases o f 11 patients who developed a syndrome, not previously described in th e literature, termed ''pseudo-CSF rhinorrhea.'' This syndrome occurs a fter surgery of the cranial base, usually involving dissection or remo val of the petrous or cavernous carotid artery, the greater superficia l petrosal nerve, and the pericarotid sympathetic plexus. It is charac terized by nasal stuffiness and nasal hypersecretion and is sometimes accompanied by facial flushing. The symptoms are characteristically ex acerbated by exertion or by elevated ambient room temperatures. Lacrim ation is typically absent ipsilateral to the pseudo-CSF rhinorrhea. It is believed that pseudo-CSF rhinorrhea developed in these patients be cause of a relative imbalance of the regulatory autonomic supply of th e nasal mucosa.