Determination of site of leak in CSF rhinorrhoea

There are different ways by which the location of leak can be determined in cases of CSF rhinorrhoea.

  • Injection of dye (flourescein / radioisotope) into intrathecal space and placing cotton pledgets in different parts of nasal cavity. Depending on which pledget gets soaked in the dye, site of leak can be determined
    • Olfactory cleft – cribriform plate
    • Sphenoethmoidal recess – Sphenoid sinus
    • Middle meatus – frontal / ethmoid sinus
    • Inferior meatus posteriorly near eustachian tube – Temporal bone – reaches via eustachian tube
  • High resolutaion CT scan – head –  coronal cuts – bone window
  • CT cisternogram – taken after injection of radioopaque dye into intrathecal space via cisterna magna
  • MRI cisternogram – T2 weighted – does not require injection of dye and is hence non invasive

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