Sinonasal Cerebrospinal Fluid (CSF) Leak
At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can access exceptional care for a sinonasal cerebrospinal fluid (CSF) leak. As a global leader in otorhinolaryngology and head and neck surgery, we are an academic-based, national and international referral site for the most complex and high-risk cases. For over a century, we have been at the forefront of innovation, research and clinical care for ear, nose and throat (ENT) and head and neck conditions.
Ranked in the top 1% of all hospitals in the nation for complex specialty care according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of ENT and head and neck conditions. Our multidisciplinary team of world-renowned specialists has pioneered many of the otorhinolaryngological techniques used today and is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.
At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can expect compassionate, personalized, research-driven treatment plans that meet the highest standards for quality and safety.
When you need CSF leak care, turn to our dedicated multidisciplinary team for a personalized treatment plan.
Montefiore Einstein offers the following content from Healthwise’s health information library.
What Are Sinonasal CSF Leaks?
A CSF leak is a condition that causes leakage of fluid surrounding the brain and spinal cord. Cerebrospinal fluid contains nutrients used by the brain and also supports both the brain and spinal cord from sudden movements. In patients with a CSF leak, there is less fluid to support and cushion the brain. When the leak is small, it may not cause symptoms. Larger leaks may cause intracranial hypotension, which can disrupt how parts of your brain function.
Causes of CSF Leaks
There is no specific known cause of a CSF leak, but it has been linked to the following conditions:
- Connective tissue disorders (e.g. Marfan Syndrome, Ehlers-Danlos syndrome)
- Intracranial hypertension
- Pseudotumor cerebri
- Obesity
- Structural defects in the nose, sinus or other parts of the skull
Symptoms & Symptoms of CSF Leaks
The most common symptom of a CSF leak is a headache that changes depending on your posture, known as a postural headache. Other symptoms of a CSF leak are dependent on the location of the leak. CSF can leak into the sinuses or into the nose. Clear fluid from your ears, known as otorrhea, is also a sign of a CSF leak. Other symptoms include:
- Blurred or double vision
- Changes in hearing or hearing loss
- Difficulty with balance
- Dizziness or vertigo
- Headaches
- Loss of appetite
- Loss of smell (anosmia)
- Nausea and/or vomiting
- Neck pain and stiffness
- Pulsatile tinnitus
- Seizures
- Sensitivity to light
Diagnosing CSF Leaks
A CSF leak is diagnosed following a complete physical examination and review of the patient’s medical history. There are several diagnostic tests for CSF leaks, including:
- CT scan
- MRI
- Nasal fluid collection and testing
- Ophthalmology examination
Treating CSF Leaks
Sinonasal CSF leaks rarely resolve on their own and typically require surgical repair as they can lead to serious infections. Endoscopic surgery performed through the nose is typically the treatment of choice for sinonasal CSF leaks. This surgery is performed using a small camera through the nose to isolate and repair the hole that is causing the fluid to leak. Often, this does not require any incisions and uses tissue from within the nose to fix the defect.