CEREBROSPINAL fluid (CSF) rhinorrhea is sometimes difficult to diagnose and treat. Trauma is the most common cause, and nontraumatic cases ("spontaneous") are considered rare. Intracranial tumors have been regarded1 as a common cause for nontraumatic rhinorrhea and the cribriform plate area in the anterior fossa as the most likely site of CSF leakage. The present paper reviews 35 cases of rhinorrhea treated at the Columbia-Presbyterian Medical Center during the past 36 years. This series is unique because of the large number of cases of rhinorrhea unassociated with trauma or tumor (11). The importance of spontaneous leakage through the middle fossa and sphenoid sinus is discussed.
The records of the Columbia-Presbyterian Medical Center were used to locate all patients with CSF rhinorrhea between 1932 and 1968. Thirty-five records were obtained.
Nine cases were associated with a definite history of trauma (Table 1). In four the rhinorrhea