Images: unilateral rhinorrhea in a patient starting autotitrating positive airway pressure therapy for obstructive sleep apnea

Abstract

We report a case of a 65-year-old obese female who developed a unilateral nasal cerebrospinal fluid leak after starting autotitrating positive airway pressure therapy for obstructive sleep apnea. The cerebrospinal fluid leak was confirmed by b-2 transferrin testing of the nasal fluid, as well as by identification of the leak through the anterior cribriform plate after administration of intrathecal fluorescein. The cerebrospinal fluid leak was successfully repaired endoscopically, and autotitrating positive airway pressure was reinitiated 1 month postoperatively.