Intranasal Endoscopic Management of Cerebrospinal Fluid Rhinorrhea

ABSTRACT

BACKGROUND: Management of patients with cerebrospinal fluid (CSF) rhinorrhea remains controversial. OBJECTIVE: The therapeutic effect of endoscopic repair of CSF rhinorrhea was evaluated. METHOD: Sixteen patients with CSF rhinorrhea involving the anterior skull base underwent intranasal endoscopic management between 1991 and 1998. Repair materials included free nasal mucosa, muscle tissue and myofascia. RESULTS: Of the sixteen patients, ten were results of head trauma, three were results of endoscopic surgery, two were at the postoperative stage of meningoma, and one was at the postoperative stage of hypophyseal adenoma. Fourteen patients had one fistula and the others two. During follow-ups lasting five months to six years, all of the cases were successfully treated without complication either intra- or post-operatively on the first attempt. CONCLUSION: The endoscopic technique provides a safe and effective means for repairing many patients with CSF rhinorrhea. Some key points to keep in mind when applying this techniques are to prepare a fresh graft recipient site and to embed free muscle into the intracranial cavity through the entrance of the dural defect.