Spontaneous Cerebrospinal Fluid Rhinorrhea: Correlation with Body Weight and Radiological Data

Abstract

Objectives:

Search for correlations between spontaneous cerebrospinal fluid rhinorrhea (SCSFR) and overweight/obesity and imaging data.

Methods:

Retrospective study of patients with SCSFR operated in a tertiary center (1993-2013). A 2-sided test was used for statistics.

Results:

There were 17 patients with SCSFR: 9 females/8 males; mean age 45 years (range, 3-84 years). Abnormalities on computed tomography (CT) were: bone defect (12), sinus opacity (11). Abnormalities on magnetic resonance imaging (MRI): continuity with meninges (7), meningocele (6), empty sella (6), dilation of optic nerve sheath (6), pneumocephalus (1). Patients underwent endoscopic closure of osteo-meningeal defect with fat. Primary success rate was 13 out of 17 (76.5%). Regarding body mass index (BMI), 12 patients out of 17 (70.6%) were overweight (BMI ≥25) versus 32% in the French general population (P = .001). Among patients with SCSFR and overweight, 3 out of 12 (25%) were obese (BMI ≥30) versus 15% in overweight individuals (P = .483). Increased pneumatization of sinuses was observed in 15 out of 17 (88%) versus 35% in the general population (P = .00009). Empty sella was found in 6 out of 17 (35.3%) versus 5.5% in the general population (P = .0002). Dilation of optic nerve sheath was observed in 6 out of 17 (35.3%) versus 10% in the general population (P = .0047).

Conclusions:

We found statistically significant correlations between SCSFR and overweight individuals, increased pneumatization of sinuses, empty sella, and dilation of optic nerve sheath, but not with obesity. This could be due to the small number of patients in this study and a weak statistical power for obesity. The 2-sided test is ideal for small samples of patients, but a greater number is needed in the future to confirm these preliminary results.