Sinus Tumors & CSF Leaks
Sinus and nasal cavity tumors are most commonly benign (non-cancerous) and do not spread to other parts of the body. These tumors typically occur on one side of the nose and are usually slow growing. Malignant (cancerous) tumors are rare. There are approximately 2,000 new cases of sinus tumors in the United States each year. Squamous cell carcinoma is the most common type of cancer found in the sinuses and nasal cavity. Other types of cancer include: adenocarcionma, lymphoma, melanoma and esthesioneuroblastoma (olfactory neuroblastoma).
If a mass is found in the nasal cavity or sinuses, the workup starts with a thorough medical history and physical examination of the head and neck. If cancer is suspected imaging of the sinuses and other parts of the body may be needed. A nasal endoscope can be used to biopsy the mass either in the office or the operating room. The biopsy specimen is then reviewed by a pathologist to determine the diagnosis.
Cerebrospinal fluid (CSF) leaks result when the fluid around the brain leaks through a hole in the dura (outer covering of the brain) and the skull bone. The fluid commonly drains from the nose depending on where the skull base defect is located.
Patients with CSF leaks complain of clear, watery drainage usually only from one side of the nose. The drainage can increase with tilting the head forward or straining. Other symptoms can include headache, visual changes, and recurrent meningitis (infection of the covering of the brain).
If you have a suspected CSF leak your surgeon at the California Sinus Centers will perform a thorough history and physical exam. If drainage can be collected it will be sent to the laboratory for testing to confirm it is CSF. Imaging studies such as CT scans or MRIs may be ordered to evaluate the skull base.
Treatment can be either medical or surgical. Conservative treatment is usually recommended first in cases of spontaneous CSF leak or head trauma. Surgical treatment of CSF leaks is used when conservative measures fail. Surgery is typically performed using an endoscopic approach (using scopes through the nostrils).
The surgeons at the California Sinus Centers are experts at the endoscopic treatment of sinus tumors and CSF leaks.
CSF Leak Repair
The doctors at Cal Sinus have extensive experience in working with difficult or revision sinus surgery cases – including repairs of CSF leaks. We are comfortable with most cases that are a result of trauma, prior surgery or that have occured spontaneously.
When other surgeons encounter leaks during surgery – they often call or refer their patients to us. Under our protocols, we do these cases at Stanford Hospital, where we are on the faculty – as private surgeons.
Most patients will stay in the hospital for 1-2 days.