title: Endoscopic Repair of CSF Fistulae: A Ten Year Experience.
abstract: BACKGROUND
  Cerebrospinal Fluid (CFF) fistulae are repaired endoscopically with varying degrees of success around the world. Large series are still uncommon, and the results varied primarily because of the different techniques by different surgeons and also because of a variation in the patient profile in each series, for example, many series deal primarily with traumatic CSF leaks where the defects are larger and outcomes poorer.
  
  
  OBJECTIVE
  To analyse the surgical outcomes of Endoscopic CSF rhinorrhea closure.
  
  
  METHODS
  This is a series of 34 cases operated upon primarily by one surgeon in two different centres over a period of 10 years.
  
  
  RESULTS
  Of the 34 cases, 76% of the patients were women. Among the patients only 20.6% patients had a history of trauma preceding the CSF leak. The most common site of leak was in the fovea ethmoidalis in 19 (55.8%) followed by 10 (29.4%) in the cribriform plate. An overlay technique of placing the multiple layers of fascia and mucosa was used in 26 (76.5%) patients and underlay technique in the remaining. Postoperative lumbar drain was used in all patients.
  
  
  CONCLUSIONS
  Based on the treatment outcome of the 34 patients, it can be concluded that the success rate of a single endoscopic procedure in our experience is 97% and 100% following the second. Endoscopic approach for closure of CSF leak is safe with minimal complications and little morbidity.
authors.affiliation: Associate Professor, Department of Otolaryngology and Head and Neck Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, Tamil Nadu, India .
authors.forename: Arun
authors.initials: A
authors.lastname: Alexander
authors.affiliation: Professor, Department of Otolaryngology and Head and Neck Surgery, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: John
authors.initials: J
authors.lastname: Mathew
authors.affiliation: Professor, Department of Otolaryngology and Head and Neck Surgery, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Ajoy Mathew
authors.initials: AM
authors.lastname: Varghese
authors.affiliation: Assistant Professor, Department of Otolaryngology and Head and Neck Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, Tamil Nadu, India .
authors.forename: Sivaraman
authors.initials: S
authors.lastname: Ganesan
keywords: Endoscopic sinus surgery; Fovea ethmoidalis; Lumbar drain