Mr imaging of cerebrospinal fluid rhinorrhea following the suboccipital approach to the cerebellopontine angle and the internal auditory canal: Report of two cases

BACKGROUND Cerebrospinal fluid (CSF) otorhinorrhea is one of the most common postoperative complications following the suboccipital approach to the cerebellopontine angle and the internal auditory canal. Accurate preoperative detection of the site of CSF leakage is important because inaccuracy may require a more extensive exploratory surgical procedure in the repair operation. There are few reports on evaluation of magnetic resonance (MR) imaging in diagnosing CSF leakage. CASE DESCRIPTION MR imaging of two cases of postoperative CSF rhinorrhea is reported. A 53-year-old woman and a 29-year-old man underwent suboccipital operations for microvascular decompression of the facial nerve in hemifacial spasm and for removal of an acoustic schwannoma, respectively. In both cases, MR findings were useful in preoperatively delineating the site of the CSF leakage, which was confirmed during the repair operation. CONCLUSION MR imaging may be useful in identifying the site of CSF leakage following the suboccipital approach to the cerebellopontine angle.