title: Treatment outcomes of endoscopic repairs of sinonasal cerebrospinal fluid leaks.
abstract: OBJECTIVE
  The objectives of the study were to evaluate the clinical characteristics of cerebrospinal fluid (CSF) leaks and determine the clinical parameters affecting endoscopic repair of CSF leaks of the anterior and central skull base.
  
  
  METHODS
  A retrospective study was undertaken to analyze the clinical characteristics of 28 patients who underwent endoscopic treatment of sinonasal CSF leaks between 2002 and 2009.
  
  
  RESULTS
  The causes of sinonasal CSF leaks were traumatic (n = 27) and spontaneous (n = 1). The sites of CSF leaks included the frontal sinus and frontal recess (n = 9), ethmoid sinus (n = 9), sella and clivus (n = 6), and sphenoid sinus (n = 4). The success rate at first-attempt endoscopic repair was 86% (24/28). Cerebrospinal fluid leaks from the frontal sinus/recess had a high failure rate (44% [4/9]). Recurrent frontal CSF leaks were successfully salvaged by an open-endoscopic approach. The final success rate at second attempt was 93% (26/28). Among the variables affecting initial endoscopic success, the location of CSF leak and direct visualization were significant factors (P = 0.008 and 0.018, respectively [Fisher exact test]). No postoperative complications were noted.
  
  
  CONCLUSIONS
  Our results showed that endoscopic repair of sinonasal CSF leaks is an effective treatment with a success rate of 93%. Open-endoscopic repair of frontal CSF leaks is feasible in treating endoscopic failures of frontal CSF leaks.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, and Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Lee
authors.forename: Sang-Chul
authors.initials: SC
authors.lastname: Lim
authors.forename: Young-Eun
authors.initials: YE
authors.lastname: Joo
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000368:Aged; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005005:Ethmoid Sinus / Q000293:injuries / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D005626:Frontal Sinus / Q000293:injuries / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000293:injuries* / Q000601:surgery; D010256:Paranasal Sinuses / Q000293:injuries* / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012658:Sella Turcica / Q000293:injuries / Q000601:surgery; D013101:Sphenoid Sinus / Q000293:injuries / Q000601:surgery; D025321:Surgery, Computer-Assisted; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult