Trans-Nasal Endoscopic Repair of CSF Rhinorrhea: An Institutional Experience

Area of Science:

• Neurosurgery
• Otolaryngology
• Rhinology

Background:

• Cerebrospinal fluid (CSF) rhinorrhea arises from a breach between the subarachnoid space and the nasal cavity.
• Endoscopic repair is the preferred treatment for CSF rhinorrhea.
• Understanding etiopathogenesis and treatment outcomes is crucial.

Purpose of the Study:

• To analyze the causes and treatment outcomes of cerebrospinal fluid (CSF) rhinorrhea.
• To evaluate the efficacy of endoscopic repair for CSF leaks.
• To identify common leak sites and associated complications.

Main Methods:

• Retrospective study of 44 patients undergoing endoscopic CSF rhinorrhea repair.
• Defect closure using a three-layer technique (fat, fascia lata, nasal mucosa) with fibrin sealant.
• Preoperative subarachnoid drain placement and 3-month follow-up.

Main Results:

• The study included 44 patients (59% male), aged 16-55 years (mean 32.8 ± 9.7).
• Post-traumatic CSF leaks accounted for 52.3% of cases, with the cribriform plate being the most common leak site.
• Endoscopic repair achieved an 88.6% success rate, with meningitis observed in 4.5% of patients (managed conservatively).

Conclusions:

• Accurate localization of the CSF leak site, particularly the cribriform plate area, is essential for successful endoscopic repair.
• Endoscopic repair demonstrates high success (88.6%) and low complication (4.5%) rates for CSF rhinorrhea.