Traumatic transnasal penetrating injury with cerebral spinal fluid leak

Authors

  • Tan Sui Teng Department of Otorhinolaryngology, Head and Neck Surgery, Serdang Hospital, Jalan Puchong, Kajang, Selangor Darul Ehsan, 43000 Malaysia, Tel: +60389475555, Fax : +60389475050, E-mail: suiteng1987@gmail.com
  • Noor Liza Ishak Ear, Nose and Throat Unit, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
  • Sethu Thakachy Subha Ear, Nose and Throat Unit, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
  • Saraiza Abu Bakar Department of Otorhinolaryngology, Head and Neck Surgery, Serdang Hospital, Jalan Puchong, Kajang, Selangor Darul Ehsan, 43000 Malaysia

DOI:

https://doi.org/10.17179/excli2018-1971

Keywords:

pencil, penetrating trauma, skull base fracture, CSF leak

Abstract

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.

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Published

2019-04-08

How to Cite

Teng, T. S., Ishak, N. L., Subha, S. T., & Bakar, S. A. (2019). Traumatic transnasal penetrating injury with cerebral spinal fluid leak. EXCLI Journal, 18, 223–228. https://doi.org/10.17179/excli2018-1971

Issue

Vol. 18 (2019)

Section

Case reports

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