Endoscopic CSF rhinorrhea closure: Our experience in 267 cases

Abstract

OBJECTIVES: The advances in endoscopic sinus surgery have made it the procedure of choice for treatment of cerebrospinal fluid rhinorrhea (CSFR). To analyze the efficacy of endoscopic closure of CSFR was the objective of the present study. METHODS: We treated 267 patients with CSFR endo-scopically. Diagnosis was achieved with the help of CT with or without cisternography, MRI, beta-2 transferrin levels. Fascia lata and fat were used to plug the defects. The patients were followed up for a minimum period of 6 months. RESULTS: CSFR was successfully plugged in 258 patients. Nine patients required revision surgery. Six could be plugged successfully endoscopically and 2 patients by a neurosurgical approach. CONCLUSIONS: In our experience with 267 patients of endoscopically treated CSFR, the results of achieving the closure was 96.63% in the first instance and 98.88% after revision surgery. SIGNIFICANCE: The transnasal endoscopic approach has excellent results in the treatment of CSFR. We recommend it as the optimum surgical approach for both primary and revisional surgical management of CSFR.