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Observation
July 2, 2020

Cerebrospinal Fluid Leak Arising From a Persistent Foramen Cecum

Author Affiliations
  • 1Tulane University, Department of Otorhinolaryngology, New Orleans, Louisiana
  • 2Ochsner Clinic Foundation Department of Otorhinolaryngology, New Orleans, Louisiana
JAMA Otolaryngol Head Neck Surg. Published online July 2, 2020. doi:10.1001/jamaoto.2020.1515

Congenital midline nasal anomalies are rare outside of childhood. We report a case of a man in his 70s with chronic rhinosinusitis who underwent image-guided endoscopic sinus surgery including Draf IIa frontal sinusotomy. During dissection, a suspected cerebrospinal fluid leak was encountered anteromedial to the right frontal ostium. The defect was repaired using a free mucosal septal graft. Review of computed tomographic (CT) imaging revealed a persistent foramen cecum. This case suggests the need to evaluate for a persistent foramen cecum as a risk factor for cerebrospinal fluid leak in adults undergoing endoscopic sinus surgery.

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