[Endoscopic closure of nasal fistulas leaking cerebrospinal fluid. Our experience]

Cerebrospinal fluid (SCF) rhinorrea results from a breakdown of the dura and supporting structures of the skull base. Trauma is responsible for 81 to 90 percent of the cases of SCF rhinorrea, and it occurs in approximately 2 percent of all head injuries. This is a retrospective review of 5 patients who underwent endoscopic treatment of CSF rhinorrea during 1997 in our hospital. The aetiology of leaks was: iatrogenic in two cases (by transphenoidal hypophysectomies), traumatic in two cases (by head injuries) and spontaneous in one (nasal encephalocele).

we recommend endoscopic approach as the first line in managing CSF rhinorrea because it avoids an external incision, requires less cumbersome instrumentation and in our hands in the safest and most successful. Furthermore, we prefer the autogenous mocuperiosteum of the inferior turbinate glued over the fistula offers several advantages: it is readily available in sufficient size for the closure of most defects, only minor surgery for graft harvesting is necessary and, the texture of the mucoperiostium permits a good secure seal.