Endoscopic endonasal repair of csf rhinorrhea : sixteen-year experience

Abstract EN

Objectives: To describe the surgical endoscopic experience of a tertiary referral center in the repair of CSF rhinorrhea, with a long-term follow-up.

Study design: Retrospective chart review with follow-up of the patients.

Materials and Methods: A total of 24 patients presented with CSF rhinorrhea (12 spontaneous, 4 traumatic, 8 iatrogenic) over a period of 16 years and were managed endoscopically by the same surgeon.

The ratio of male to female patients was 11:13.

The age ranged from 4 to 64 years.

The leak was more commonly seen on the right side.

Pre-operative CT with intrathecal metrizamide was obtained in 20 patients.

Temporalis muscle, fascia, and fibrin glue were used in all patients. Results: The location of the defect was most commonly found in the cribriform plate (50 %).

Other locations included the fovea ethmoidalis, and lateral wall of the sphenoid.

A lumbar drain was used in 6 patients.

The follow-up period ranged from 1 month to 16 years.

Successful repair was obtained in 22 patients with recurrence of leak in 2 patients (8.3 %). No major complications were encountered. Conclusion: The endoscopic endonasal approach is a safe and effective method of treatment in patients with CSF rhinorrhea, sparing them the morbidity of the extra-cranial approach.

Our results are comparable to those in the literature.

CT scan with intrathecal metrizamide can enhance pre-operative diagnosis and aid in determining the site of leak.