Endoscopic Transnasal Repair of Cerebrospinal Fluid Rhinorrhea - Analysis of 400 Cases

Objective: To describe our experience and outcome of transnasal endoscopic CSF leak repair in 400 patients. Materials and methods: It was a retrospective study of 400 cases operated over a period of 19 years. Results: 400 patients were reviewed. Of this, 62 % had spontaneous leaks and the rest of patients were found to have leak secondary to trauma. 6 cases were congenital. Age of the patients was between 30-50 years except congenital cases where majority were less than 10 years. CT Cisternography was our choice of radiological imaging, which had a success rate of 95% in detecting the defect. Most common CSF leak in our study was cribriform plate and the least was lateral recess or Sternberg’s canal (1.5%). Our success rate in defect closure was 98% in the first attempt and 100% during the second attempt. Mean hospital stay was found to be 0.75 days. No major complications were encountered following the surgery. Conclusion: Our experience of endoscopic transnasal repair of CSF leaks is very good. Multi-layered closure is advocated. Hadad Bassagasteguy flap has been observed to be a good graft material. We urge the use of endoscopic repair due to better outcome and less morbidity.