Transorbital frontoethmoidectomy approach to the repair of cerebrospinal fluid rhinorrhea

Sixteen patients, presenting with cerebrospinal fluid leak, were operated upon using the transorbital frontoethmoidectomy (TOFE) approach for closure of the leak. The most common etioIogy in our series was trauma (87%), with accidental trauma being the most frequent type. Metrizamide CT scanning was found to be very useful in identifying the presence and site of the leak. The fovea ethmoidalis and the cribriform plate were found to be the commonest sites of leak. The TOFE approach offered adequate exposure of the orbit and paranasal sinuses as well as good cosmesis, no postoperative anosmia and the use of the operating microscope to preserve vital structures.