Nasal endoscopic repair of cerebrospinal fluid rhinorrhea: case series of ten patients

Abstract

Background: CSF rhinorrhea is a rare entity but it needs proper evaluation and management. Previously it was managed through intracranial approach carrying increased morbidity and mortality. Since the introduction of nasal endoscopic surgery in 1981, it is being managed through transnasal endoscopic technique which has high success rate and less morbidity. The purpose of this study was to review the clinical presentation, etiology, diagnosis and outcome of nasal endoscopic repair in CSF rhinorrhea.

Methods: It was a retrospective multicentre review of the records of the patients from January 2005 to December 2010. Data was collected on a detailed proforma. Patients with incomplete or missing data were excluded.

Results: Total number of patients undergoing nasal endoscopic repair for CSF rhinorrhea was 10; 7(70%) females and 3(30%) males. Mean age at the time of repair was 39.5+4.3 years. CT scan was performed in all patients, CT cisternography in 3 and MRI in 4 patients to rule out any encephalocele. Majority of leaks were found at the cribriform area. In 6(60%), muochondrial graft were used while in 4(40%) patients septal cartilage as well as mucoperichondrial graft were used. In 7(70%) patients nose was packed with gelfoam and in 3(30%) vaseline nasal packs were used. Lumber drain was placed only in 2 patients. No complication was encountered in follow-up period.

Conclusion: Nasal endoscopic technique is an effective method in closing CSF leak.