Transnasal endoscopic repair of cerebrospinal fluid rhinorrhoea

The complications associated with the employment of neurosurgical techniques for the management of cerebrospinal fluid rhinorrhoea has led to the development of extracranial approaches. The nasal endoscope can be used to improve visualisation of the site of the leak and to facilitate free graft or septal flap placement. This ensures a high rate of dural defect healing with minimal morbidity. This study describes four cases with CSF fistulas that were repaired endoscopically and the specific surgical techniques that were used. The authors believe that, in carefully selected cases, transnasal endoscopic management of CSF leaks can be the initial surgical treatment of choice.