Endoscopic endonasal approaches for repair of cerebrospinal fluid rhinorrhea
Abstract: Objective: To describe surgical experience in repair of cerebrospinal fluid (CSF) rhinorrhea treated by endoscopic transnasal approaches. Methods: Between October 2003 and December 2008, 38 patients with CSF rhinorrhea were treated. Endoscopic endonasal approaches and surgical techniques in the repair of CSF leaks are reviewed in the series of 38 patients included 12 patients with traumatic CSF leaks, 10 patients with spontaneous CSF leaks, and 16patients with other reason. Results: Follow-up 6 months to 3 years postoperative, successful rate at first attempt was 94.7%. 1 patient needed a Second surgical repair and one patient a third surgical repair. The complication included meningitis and obstruction hydrocephalus in two patients. Conclusions: The endoscopic endonasal approaches is first choice for repair of CSF leak for its minimal invasive injure and high successful rate. Leak site identification, site preparation, accurate graft placement and postoperative management are critical to achieve a high level of success.
Keywords: Cerebrospinal fluid leaks, Cranium base, Surgery, Endonasal surgery, Endoscope