title: Neuroendoscopic endonasal management of cerebrospinal fluid rhinorrhea.
abstract: Neuroendoscopic endonasal approach has gained popularity in managing traumatic, spontaneous, and especially iatrogenic cerebrospinal fluid (CSF) rhinorrhea. The authors examined 8 patients presenting with CSF rhinorrhea between December 2012 and June 2014: 5 patients had iatrogenic leak, 2 patients had traumatic leak, and 1 patient had a spontaneous onset of CSF rhinorrhea. Sites of the CSF leaks were detected through computed tomographic cisternography and magnetic resonance imaging in the patients with traumatic and spontaneous leaks. All patients received neuroendoscopic endonasal surgery for the CSF leak. The largest defect was 22 mm in maximum diameter. Endoscopic supraciliary "keyhole" approach was performed in 1 patient after confirmation of a frontal sinus leak using the endoscopic endonasal approach. The success rate was 100% in the first attempt. Follow-up period ranged from 3 to 24 months, and no recurrence was reported. Identifying the leak site and choosing the appropriate surgical technique remain the most important factor in surgical success.
authors.affiliation: From the *Department of Neurosurgery, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital), Shenzhen; and †Shantou University Medical College, Shantou, China.
authors.forename: Wen-Jian
authors.initials: WJ
authors.lastname: Zheng
authors.forename: Xie-Jun
authors.initials: XJ
authors.lastname: Zhang
authors.forename: Tao
authors.initials: T
authors.lastname: Ji
authors.forename: Guo-Dong
authors.initials: GD
authors.lastname: Huang
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000328:Adult; D000368:Aged; D014695:Cerebral Ventriculography / Q000379:methods; D002559:Cerebrospinal Fluid Rhinorrhea / Q000000981:diagnostic imaging / Q000601:surgery*; D005206:Fascia Lata / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D009297:Nasal Mucosa / Q000637:transplantation; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D044583:Neuroendoscopy / Q000379:methods*; D009666:Nose / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome