Endonasal Endoscopic Repair of Cerebrospinal Fluid Leaks

Objective: To assess the outcome of Endonasal Endoscopic Repair of Cerebrospinal Fluid Leaks. Methods and Materials: This study was conducted from July 2013 to October 2014 at the department of Neuro-surgery, PGMI, Lahore General Hospital, Lahore. A total of 20 patients were included in this study of both gender (male and female) and in the age range of 15 – 65 years. All the patients undergone Endonasal Endo-scopic with the use of a Karl Stortz rigid endoscope of 0o and 30o with a 4mm diameter. All of them were followed up for recurrence of CSF leak and any postoperative complication. Results: Out of 20 patients, there were 08 (40%) males and 12 (60%) female patients. Their age ranged from 15 – 65 years. The maximum numbers of patients were in their third and fourth decade of life. The cause of CSF leak was spontaneous in 11(55%), iatrogenic in 5 (25%) and traumatic in 4 (20%) of cases. In 13 (65%) patients, CSF rhinorrhea was from right nostril and in 7 (35%) patients left side was affected. Endonasal Endoscopic CSF repair was done in all patients and was successful in 18 (90%) of patients. Two patients (10%) presented with recurrence of CSF leak in which one was successfully re-operated endoscopically and other undergone trans- cranial approach. Overall the success rate was 95% in our study. Only one patient complicates with meningitis postoperatively which was resolved with antibiotics. Conclusion: The repair of the CSF rhinorrhea by Endonasal Endoscopic surgery is minimal invasive, safe, effective and is a valid alternative to the cranial approach. Keywords: Endonasal Endoscopic repair, Cerebrospinal Fluid Leaks. Abbreviations: CSF: Cerebrospinal Fluid. MRI: Magnetic Resonance Imaging.