title: Distant pseudomeningoceles of the ventral skull base: a report of 2 cases.
abstract: BACKGROUND
  The objective of this case series was to report what is to the best of our knowledge the first reports of nasopharyngeal and soft palate pseudomeningoceles tracking submucosally from the sphenoid sinus.
  
  
  METHODS
  Analysis of cases through medical records.
  
  
  RESULTS
  Two cases of middle-aged male patients presented to our tertiary care university teaching hospital for recurrent meningitis and a history of cerebrospinal fluid (CSF) rhinorrhea. Both were found to have pseudomeningoceles distant from the sphenoid sinus. One was tracking to the mucosa of the Eustachian tube, and the other to the dorsum of the soft palate. Both were found to be tracking submucosally from the sphenoid sinus, to the vidian canal, to the lateral nasopharyngeal wall, to their respective locations at the Eustachian tube and dorsum of the soft palate. CSF closure was performed with a transnasal endoscopic repair using the pedicled nasoseptal flap for 1 patient and Alloderm for the other, both with successful cessation of CSF rhinorrhea.
  
  
  CONCLUSIONS
  We present these cases of distant spontaneous CSF leaks. We review the literature and discuss case management.
authors.affiliation: Department of Otolaryngology, New York University (NYU), New York, NY.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Lieberman
authors.forename: Rosemary B
authors.initials: RB
authors.lastname: Ojo
authors.forename: Roy R
authors.initials: RR
authors.lastname: Casiano
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery*; D003094:Collagen; D005064:Eustachian Tube / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: C440568:Alloderm; D003094:Collagen
keywords: CSF fistula; CSF rhinorrhea; endoscopic CSF leak repair; endoscopic sinus surgery; meningocele; pseudomeningocele; spontaneous CSF leak