Endoscopic management of cerebrospinal fluid fistulae and traumatic cephalocoele

The excellent visualisation and atraumatic surgical techniques of endoscopic sinus surgery were applied to the management of 5 patients with cerebrospinal fluid (CSF) fistulae in the anterior skull base. The CSF fistula was iatrogenic in three patients, post-traumatic in one patient and primary in another patient. The role of endoscopes in the diagnosis and management of CSF rhinorrhoea is discussed. These five case reports illustrate the use of rigid transnasal endoscopy for diagnosis and management of CSF fistulae. The use of endoscopes allowed us to accurately localise and repair CSF fistulae. Our technique and results of endoscopic management of CSF fistulae are discussed. Using the endoscopic transnasal approach and minimally invasive techniques the fistulae were successfully repaired in all 5 patients.