Abstract
Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare. Careful history taking and a low threshold of suspicion are needed in its correct diagnosis. Biochemical analysis of nasal discharge is essential, but clinically it may be difficult to collect sufficient samples for study. It is a general rule to have accurately identified the location of the leak before attempting surgery. Imaging modalities such as computed tomography (CT) and magnetic resonance (MR) cisternography help in localizing the site of the defect. If not treated properly, this seemingly innocent condition can lead to serious complications such as meningitis and even death. As to the surgical repair, there is no universal technique. Traditionally, the solution to this condition has been open repairs via extracranial or intracranial approach. In this article, we report three cases of spontaneous CSF rhinorrhea successfully repaired via endonasal endoscopes. Although spontaneous CSF leaks are most challenging to repair due to identification of their locations, the high success rates in our experience using endonasal endoscopy are encouraging. Otolaryngologists provide an alternative solution to this challenging clinical problem.
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