Evaluation of the role of high-resolution CT and MR cisternography in preoperative identification of skull base defect in cases of CSF rhinorrhea

Abstract EN

Preoperative identification of the site of CSF fistula and skull base defect accurately enhances the chance of successful surgical repair.

High-resolution CT (HRCT) is highly effective in demonstration of the bony defect at the site of the leak.

MR Cisternography can detect a CSF fistula by the bright signal of CSF on T2-weighted images. Objectives: To determine the accuracy of combined HRCT and MR Cisternography in preoperative identification of skull base defect in patients with CSF rhinorrhea.

Methods: Ninety three patients were subjected to combined non-contrast HRCT of the nose and paranasal sinuses and MR Cisternography to identify the site of the leak.

Results: In all the patients, combined HRCT and MR Cisternography can detect skull base defects with a sensitivity of 96% and specificity of 90 %.

Conclusion: HRCT combined with MR Cisternography are accurate and non-invasive methods for localization of the skull base defect