Single-layer Endoscopic Repair of Anterior Skull Base Defects

This article reviews contemporary strategies for single-layer endoscopic repair of anterior skull base cerebrospinal fluid leaks, which are important for small defects and when multiple layers using vascularized tissue options are not available. Successful reconstruction requires restoring a watertight barrier between the intracranial compartment and the sinonasal tract, with technique selection guided by defect size, location, flow dynamics, and tissue availability. When appropriately selected, patients undergoing single-layer endoscopic repair achieve closure rates exceeding 90%. The article also discusses factors associated with failure and practical considerations for enhancing durability, highlighting the ongoing relevance of single-layer reconstruction in modern skull base surgery.