Causes

Causes of CSF rhinorrhoea include:

• Fracture of the anterior skull base
• Iatrogenic following surgery
• Spontaneous leak

Presentation

Watery nasal discharge should raise the suspicion of CSF rhinorrhoea, especially if discharge is increased on bending forwards.

Investigations

• The current standard in diagnosis of anterior skull base fracture is CT (axial and coronal planes).
• Other investigations done as part of patient work-up could include glucose oxidase or transferrin analysis in nasal secretions (beta 2 transferrin test).