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A Rare Case of Cerebrospinal Fluid Rhinorrhea from Canal of Stenberg

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Abstract

Background: A spontaneous cerebrospinal leak from Sternberg’s canal with meningoencephalocele is a very rare clinical entity. Endoscopic repair of the defect is challenging and crucial in identifying the defect. The aim of this case report is to highlight the presence and management with endoscopic surgery in repairing Sternberg canal. Case: 40-year-old woman presents with spontaneous CSF rhinorrhea with no predisposing factors. CT imaging and MRI showed osteodural defect in the lateral recess of sphenoid with meningoencephalocoele lateral to the foramen rotundum. Endoscopic transethmoidal - transphenoidal - transpterygoid approach was used to repair the defect, and patient is well post-operative with least complication from the intervention surgery. Conclusion: Endoscopic approach proved to be the best and safest method in localizing the defect and closure of the leak. Angled scopes and image guided system were used to identify the precise location of the leak.

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References

  1. Jayaprakash N, Kumar RR, Devanand B, Vaishnavi VA (2017) Sternberg’s canal - A rare cause of spontaneous cerebrospinal fluid rhinorrhea. Neurol India 65(6):1429–1430. doi: https://doi.org/10.4103/0028-3886.217954

    Article  CAS  PubMed  Google Scholar 

  2. Tomaszewska M, Brożek-Mądry E, Krzeski A (2015) Spontaneous sphenoid sinus cerebrospinal fluid leak and meningoencephalocele - are they due to patent Sternberg’s canal? Wideochirurgia i inne techniki maloinwazyjne = videosurgery and other miniinvasive techniques. 10:347–358. https://doi.org/10.5114/wiitm.2014.47097. 2

  3. Mokri B (2013) Spontaneous low pressure, low CSF volume headaches: spontaneous CSF leaks. Headache 53(7):1034–1053. doi: https://doi.org/10.1111/head.12149

    Article  PubMed  Google Scholar 

  4. Bendersky DC, Landriel FA, Ajler PM, Hem SM, Carrizo AG (2011) Sternberg’s canal as a cause of encephalocele within the lateral recess of the sphenoid sinus: a report of two cases. Surg Neurol Int 2:171. doi: https://doi.org/10.4103/2152-7806.90034

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lai SY, Kennedy DW, Bolger WE (2002) Sphenoid encephaloceles: disease management and identification of lesions within the lateral recess of the sphenoid sinus. Laryngoscope 112(10):1800–1805. doi: https://doi.org/10.1097/00005537-200210000-00018

    Article  PubMed  Google Scholar 

  6. Barañano CF, Cure J, Palmer JN, Woodworth BA (2009) Sternberg’s Canal: fact or fiction? Am J Rhinol Allergy 23(2):167–171. doi: https://doi.org/10.2500/ajra.2009.23.3290

    Article  PubMed  Google Scholar 

  7. Schick B, Brors D, Prescher A (2000) Sternberg’s canal–cause of congenital sphenoidal meningocele. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the german society for Oto-Rhino-Laryngology -. Head and Neck Surgery 257(8):430–432. doi: https://doi.org/10.1007/s004050000235

    Article  CAS  Google Scholar 

  8. Wang J, Bidari S, Inoue K, Yang H, Rhoton A (2010) Jr. Extensions of the sphenoid sinus: a new classification. Neurosurgery 66(4):797–816. doi: https://doi.org/10.1227/01.neu.0000367619.24800.b1

    Article  PubMed  Google Scholar 

  9. Thakur JD, Manzi B, Savardekar AR, Singh MP, Menger R, Nanda A (2018) Commentary: Maximilian Sternberg (1863–1934): the Man behind Sternberg’s Canal and his contribution to the Modern-Day Skull Base anatomy and neuroscience-historical vignette. Neurosurgery 83(3):E120–e4. doi: https://doi.org/10.1093/neuros/nyy242

    Article  PubMed  Google Scholar 

  10. Hanwate R, Thorawade V, Jagade M, Attakil A, Parelkar K, Pandare M et al (2015) CSF rhinorrhoea with encephalocele through Sternberg’s canal: our experience. Int J Otolaryngol Head Neck Surg 04:50–54. doi: https://doi.org/10.4236/ijohns.2015.41009

    Article  Google Scholar 

  11. Mokri B (2013) Spontaneous Low Pressure, Low CSF Volume Headaches: Spontaneous CSF Leaks. Headache: The Journal of Head and Face Pain. ;53(7):1034-53. doi: https://doi.org/10.1111/head.12149

  12. Chen GY, Ma L, Xu ML, Zhang JN, He ZD, He CY et al (2018) Spontaneous cerebrospinal fluid rhinorrhea: a case report and analysis.Medicine. ; 97(5)

  13. Connor SE (2010) Imaging of skull-base cephalocoeles and cerebrospinal fluid leaks. Clin Radiol 65(10):832–841. doi: https://doi.org/10.1016/j.crad.2010.05.002

    Article  CAS  PubMed  Google Scholar 

  14. Castelnuovo P, Dallan I, Pistochini A, Battaglia P, Locatelli D, Bignami M (2007) Endonasal endoscopic repair of Sternberg’s canal cerebrospinal fluid leaks. Laryngoscope 117(2):345–349. doi: https://doi.org/10.1097/01.mlg.0000251452.90657.3a

    Article  PubMed  Google Scholar 

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Originality statement: We are declaring that this manuscript is our own work, it is not under consideration by another journal, and this material has not been previously published.

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Correspondence to CHIEN YING VINCENT NGU.

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NGU, C.V., LEE, T.H., RAMACHANDRAN, K. et al. A Rare Case of Cerebrospinal Fluid Rhinorrhea from Canal of Stenberg. Indian J Otolaryngol Head Neck Surg 75 (Suppl 1), 764–767 (2023). https://doi.org/10.1007/s12070-022-03347-z

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