title: Endoscopic transnasal cerebrospinal fluid leak repair: a 10 year experience.
abstract: BACKGROUND
  Endoscopic techniques have gained popularity for the repair of anterior skull base defects.
  
  
  OBJECTIVE
  To describe the 10 year experience with endoscopic surgical repair of cerebrospinal fluid (CSF) rhinorrhea in a tertiary medical center.
  
  
  METHODS
  The files of all patients who underwent endoscopic transnasal CSF leak repair in our institution between 1996 and 2006 were reviewed.
  
  
  RESULTS
  Twenty-four patients were identified: 16 women and 7 men with a mean age of 48 years and one child aged 9.5 years. The leak was trauma-induced in 17 patients and occurred spontaneously in the other 7. The defect was localized by preoperative computed tomography or CT/cysternography in 86% of cases. A fascia lata graft was the dominant choice for defect closure, and it was combined with a conchal or septal flap, fat, periosteum, or fibrin glue in 15 patients. The success rate was 83% after the first closure attempt and 91% after the second. Two patients required a craniotomy at the third attempt. Mean hospitalization time was 6.7 days. There were two minor complications. Two patients were lost to follow-up; none of the others had a recurrence during 2 years of follow-up.
  
  
  CONCLUSIONS
  The endoscopic transnasal technique for the repair of CSF rhinorrhea is associated with a high success rate and low morbidity, and it should be considered for the majority of cases. Repeated attempts may improve success.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Nose and Sinus Institute, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
authors.forename: Hanna
authors.initials: H
authors.lastname: Gilat
authors.forename: Zvi
authors.initials: Z
authors.lastname: Rappaport
authors.forename: Eitan
authors.initials: E
authors.lastname: Yaniv
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005206:Fascia Lata / Q000637:transplantation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous