Background: Patients with spontaneous cerebrospinal fluid (CSF) rhinorrhea can experience significant sinonasal symptom burden, leading to poor quality of life. The objective of this study is to investigate sinonasal outcome test (SNOT)-22 quality of life (QOL) scores in patients undergoing endoscopic endonasal surgery for spontaneous CSF rhinorrhea and compare them to patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis without nasal polyps (CRSsNP).
Methods: A multi-institutional retrospective review of patients with spontaneous CSF rhinorrhea and CRSsNP was performed. Individual SNOT-22 scores and domain scores were compared between the two diseases after surgical intervention.
Results: Ninety-one patients were included in the spontaneous CSF rhinorrhea group and 105 patients were included in the CRSsNP group. Post-surgery, both groups experienced similar improvements in total SNOT-22 scores. However, the CSF rhinorrhea group improved significantly more in runny nose (P < 0.001), postnasal discharge (P < 0.001), wake up at night (P = 0.031), and embarrassed (P = 0.002) along with the sleep dysfunction domain (P = 0.025) while the CRSsNP group improved significantly more in the four cardinal symptoms of chronic rhinosinusitis (CRS) and in the ear/facial domain (P = 0.005).
Conclusion:Patients with spontaneous CSF rhinorrhea can experience significant sinonasal symptom burden, leading to poor QOL. Those who undergo CSF leak repair experience significant improvement in symptom burden and QOL similar to patients who undergo ESS for CRS, especially in the symptoms of runny nose, post-nasal discharge, waking up at night, feeling embarrassed, and sleep dysfunction.