Transnasal endoscopic repair of cranionasal fistulae: a refined technique with long-term follow-up.

Although the management of cranionasal fistulae has historically plagued otolaryngologists, recent reports of endoscopic techniques for repair of these lesions offer promising results. We present our series of 42 patients whose cranionasal fistulae were managed endoscopically between December 1989 and August 1995. Follow-up ranged from 5 to 68 months, thereby including long-term results from our previously reported series of 29 cases. Resolution of cerebrospinal fluid rhinorrhea was achieved in 35 (83.3%) of 42 patients with one endoscopic procedure, and 3 patients had successful closure at a second surgery. All five cephaloceles were successfully treated with one procedure. We have refined our technique to include specific indications for the use of free grafts depending on the location and size of the cranionasal fistula.