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. 2001;11(1):47–58. doi: 10.1055/s-2001-12787

Endonasal Endoscopic Closure of Cerebrospinal Fluid Rhinorrhea

S Schmerber, Ch Righini, J-P Lavielle, J-G Passagia, E Reyt
PMCID: PMC1656831  PMID: 17167603

Abstract

The authors review their experience with endoscopic repair of skull base defects associated with cerebrospinal fluid (CSF) rhinorrhea involving the paranasal sinuses. A total of 22 patients was treated endoscopically between 1992 and 1998. The repair method consisted of closure of the CSF fistula with a free autologous abdominal fat graft and fibrin glue, supported with a sheet of silastic. The primary closure rate was 82% (18/22), and the overall closure rate was 95.5% (21/22) without recurrence or complications within an average follow-up of 5 years (14-83 months). A single patient still complains of cerebrospinal rhinorrhea, although this was never proved by any clinical, endoscopic, or biological (β2-transferrin) examination. The repair of ethmoidal-sphenoidal cerebrospinal fluid fistulae by endonasal endoscopic surgery is an excellent technique, both safe and effective. Fat is a material of choice, as it is tight and resists infection well. The technique and indications for endoscopic management of cerebrospinal fluid leaks are discussed.

Keywords: Cerebrospinal fluid rhinorrhea, fat graft, endoscopic treatment, anterior cranial fossa, ethmoid, sphenoidal sinus, MRI cisternography

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