Differentiation between CSF Otorrhea and Rhinorrhea in an Obscure Case of Recurrent Meningitis.

INTRODUCTION: Leakage of cerebrospinal fluid in the skull base may be accompanied with recurrent meningitis. The site of leakage may either be anterior (in the nose and paranasal sinuses) or posterior (in the temporal bone). Various imaging techniques can be used to precisely locate the point of leakage but despite all the advances in imaging techniques there are still some rare cases in which the surgeon can't be sure on the management approach before the beginning of surgery. CASE REPORT: In this article we present one of these cases; we used intrathecal fluorescein to locate the source of the leak and made the final decision on the operating table. CONCLUSION: Intrathecal fluorescein is helpful in locating the leakage in the ear or the nose in ambiguous cases.

Nasal Septum Perforation due to Methamphetamine abuse.

INTRODUCTION: Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation. CASE REPORT: This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine. CONCLUSIONS: Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.