Endoscopic endonasal approaches for repair of cerebrospinal fluid rhinorrhea

OBJECTIVE To describe the surgical experience in the repair of cerebrospinal fluid (CSF)rhinorrhea treated by endoscopic transnasal approaches. METHODS From Oct. 2003 to Dec. 2008, 38 patients with CSF rhinorrhea were treated. Endoscopic endonasal approaches and surgical techniques in repair of CSF leaks were reviewed in a series of 38 patients included 21 patients with traumatic CSF leakage, 10 patients with spontaneous CSF leakage, and 7 patients with other reasons. RESULTS Followup of 6 months to 3 years after operation, successful rate at first attempt was 92.1%. Two patients needed a second surgical repair and one patient a third surgical repair. The complications included meningitis and acute obstructive hydrocephalus in two patients respectively. CONCLUSION The endoscopic endonasal approaches is the first choice for repair of CSF leakage for its minimal invasive injury and high successful rate. Leakage site identification, site preparation, accurate graft placement and postoperative management are critical to the success of operation.