Post-traumatic cerebrospinal fluid rhinorrhea associated with craniofacial fibrous dysplasia:Case report and literature review

作     者：Peng Li Qiangyi Zhou Zhijun Yang Zhenmin Wang Shiwei Li Xingchao Wang Bo Wang Fu Zhao Pinan Liu 

作者机构：Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University Department of Neural Reconstruction Beijing Neurosurgery Institute Capital Medical University 

出 版 物：《Translational Neuroscience and Clinics》 (临床转化神经医学（英文版）)

年 卷 期：2016年第2卷第3期

页      面：188-194页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：the National Science and Technology Support Program of the 12th Five-Year of China(grant number:2012BAI12B03) Natural Science Foundation of Beijing(grant number:7112049) 

主　　题：craniofacial fibrous dysplasia cerebrospinal fluid rhinorrhea post-traumatic literature review 

摘      要：Objective: Fibrous dysplasia(FD) is an unusual developmental abnormality of the skeleton. When facial and cranial bones are involved in FD, it is termed craniofacial fibrous dysplasia(CFD). Although several reports have reported that CFD has a tendency for spontaneous cerebrospinal fluid(CSF) leakage, there have been no related English-language case reports. We present the first case of post-traumatic CSF rhinorrhea associated with CFD. Methods: A 30-year-old man presented with CSF rhinorrhea after a mild head trauma. Computed tomography cisternogram located a defect in the posterior wall of the right frontal sinus. Imaging examination also showed the evident expansion of multiple skull bones, spinal scoliosis, and multiple local enlargements of *** café-au-lait cutaneous spots and endocrine abnormalities, polyostotic FD was diagnosed instead of Mc Cune-Albright syndrome(MAS). The patient underwent craniotomy fistula repair surgery. The excised bone was contoured to be thinner to increase the cranial cavity. The patient recovered well and CSF leakage did not *** during a nineteen-month follow up, sight in the patient s left eye was *** was suspected. Unfortunately the patient refused to take the proposed decompression surgery and laboratory tests of serum hormones. Conclusions: CFD, if the wall of the paranasal sinus is involved and the cranial cavity is decreased, may increase the risk of CSF rhinorrhea after head *** management is recommended in asymptomatic CFD patients even in the presence of optic nerve compression. As MAS may cause more problems, it should be precluded before polyostotic FD is diagnosed.