Updated: Cerebrospinal Fluid (CSF) Leak After Skull Base Injury Following Nasal Swab Test for COVID-19

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Updated May 21, 2023

More on the “The Covid testing swabs debacle” from Norman Fenton, Professor Emeritus of Risk.

Access the full substack article here

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Original Post January 4, 2022

A recent study published in September issue of the JAMA Otolaryngology Head Neck Surgery presented “a case of cerebrospinal fluid (CSF) leak after skull base injury following nasal swab testing for COVID-19 in a patient with a previously intact skull base”. 

The article states, a spinal fluid leak is a rare but a serious complication caused by the medical examination after nasal swab testing for COVID-19 requiring endonasal endoscopic closure. The defect required a graft using the temporal muscle fascia as an underlay graft while mucosal tissue grafted from inside the nose was used as an overlay graft that was fixed with a fibrin glue.

Three weeks after the surgery the patient reported no ability to smell from the right nostril. 

The study concluded with,

“Complications after nasal swab testing can be expected during the COVID-19 pandemic owing to an increase in nasal swab testing. Every instance of unilateral clear water rhinorrhea that appears after transnasal testing must be considered a potential CSF leak. To our knowledge this is the first case report presenting CSF fistula following the nasal swab testing in a healthy man with no preexisting skull base condition”.

Access the study on Skull injury After Nasal Swab Testing for COVID-19 here

 

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