Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: an analysis of 22 cases.

The purpose of this study was to investigate and summarize the surgical procedure and efficacy of transnasal endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea. This is a retrospective study including 22 patients with CSF rhinorrhea who underwent transnasal endoscopic repair between January 2003 and August 2010. The location of the lesion was determined by both HRCT scan and intranasal endoscopy, and the lesion was repaired with a graft from autologous thigh muscle fascia. The grafts were placed and fixed above (inlay) or beneath (onlay) the lesions or defects. The causes of CSF rhinorrhea in our study included trauma, surgical injury, and meningoencephalocele, or idiopathic etiology. There were 15 of 17 patients with histories of trauma or surgical injury who were found to have defects in skull base by HRCT examination. The other 5 patients had an intact skull base, minor local osteoporosis, or bone resorption. All 22 patients had no reoccurrence of CSF rhinorrhea during the follow-up period, which ranges from 4 to 72 months. The transnasal endoscopic approach is a safe and effective procedure, with minimal invasion, for the repair of CSF rhinorrhea.