ENDOSCOPIC MANAGEMENT OF CEREBROSPINAL FLUID RHINORRHEA FROM ANTERIOR SKULL BASE DEFECTS

Background: Over the past 20 years, the minimally invasive endoscopic approach has gained widespread acceptance. The study was performed to evaluate the diagnostic method and the success rate of endoscopically diagnosed and treated CSF rhinorrhea, and also investigations such as leakage site and etiologic factor. Methods: This retrospective CSF leakage management review of patients experiencing CSF rhinorrhea made from 1999-2006 included data regarding leakage etiology, preoperative assessment, intraoperative techniques and postoperative followup. Result: Sixty-five patients were managed endoscopically. CSF rhinorrhea etiology was traumatic in 30 cases, iatrogenic in 23 and spontaneous in 12. We used nasal endoscopy and high resolution computed tomography (HRCT) in all 65 cases while CT metrizamide cisternography was used in 5 specifically and magnetic resonance imaging for 5 others. Intrathecal fluorescein was used for intraoperative assessment without complications, and only one case of meningismus was noted. Conclusion: Several imaging methods were effective in diagnosing CSF leakage sites. Endoscopic management and autografts were successful in repairing anterior skull defects in 90.76% of the cases