Cerebrospinal fluid (CSF) leak can arise as a complication of trauma, hydrocephalus, endoscopic sinus surgery, or it may occur spontaneously without any identifiable cause. Surgical repair is recommended in patients who do not respond to the conservative management. In recent years, transnasal endoscopic approach has become the preferred method for repairing CSF leaks, and better outcomes have been reported as compared with the intracranial approaches that were previously used. The objective of this study was to analyze the outcome of transnasal endoscopic repair of CSF rhinorrhea.

This prospective study was conducted in the Department of ENT, B.J. Medical College, Ahmedabad, India, from April 2013 to July 2016. Twenty-five patients with CSF rhinorrhea were included in the study. They were diagnosed based on the clinical evaluation, computed tomography, and magnetic resonance imaging. These patients did not respond to conservative management and were operated transnasally using rigid endoscope. Patients were followed up for a mean duration of 9 months, and the outcome was analyzed.

The patients included in the study ranged in the age group of 12 to 55 years. Among the patients, 15 were females and 10 were males. The cause of CSF rhinorrhea was traumatic in 18, idiopathic or spontaneous in 7. In 12 patients, the site of leak was cribriform plate, 6 from ethmoid, 5 from sphenoid sinus, and in 2 frontal sinuses were affected. Primary surgery was successful in 23 of cases. In two cases, reexploration had to be performed. Overall success rate was 100%.

Transnasal endoscopic repair of CSF rhinorrhea is highly successful, safe, and less traumatic.

Gupta DP, Dinesh SK, Manavadaria AD. Transnasal Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea. Clin Rhinol An Int J 2017;10(2):45-48.