Abstract
Background: Cerebrospinal fluid (CSF) rhinorrhea results from abnormal communication between the subarachnoid space and the nasal cavities. During the last two decades the surgical management of anterior skull base fistulae has evolved from intracranial craniotomy to endoscopic transnasal repair with a high success rate and decreased morbidity. We recently changed our policy and repair CSF rhinorrhea through an endoscopic endonasal approach. The purpose of this work is to describe the technique used for watertight closure of CSF leak along the anterior skull base and to evaluate our early results. Methods: A prospective acquired database of all patients having undergone endonasal endoscopic repair of CSF leaks over a 20-month period at Military Hospital of Tunis starting in March, 2012 was reviewed. Results: A total of 20 patients underwent endoscopic repair of CSF fistula. The etiology was traumatic in 7 cases, spontaneous in 11, and iatrogenic in 2 associated with previous transsphenoidal pituitary surgery. A total of 19 patients had successful primary endoscopic repair of the CSF leak. One patient required a revision surgery due to early failure of the repair and the leak was plugged successfully on the second attempt. We experienced a single case of meningitis during the postoperative course. Conclusion: The overall success rate (100%) and low morbidity in this short series support endoscopic approach as standard of care for CSF leak closure.
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Schedule a callMore From: Journal of Neurological Surgery Part B: Skull Base
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