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Treatment Outcomes of Endoscopic Repairs of Sinonasal Cerebrospinal Fluid Leaks

Lee, Dong-Hoon MD*; Lim, Sang-Chul MD, PhD*; Joo, Young-Eun MD, PhD

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1266-1270
doi: 10.1097/SCS.0b013e31821c6ad3
Original Articles

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.

Materials and 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.

From the *Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, and Chonnam National University Hwasun Hospital, Hwasun; and †Research Institute of Medical Sciences, Chonnam National University Medical School, Gwangju, Korea.

Received November 23, 2010.

Accepted for publication December 6, 2010.

Address correspondence and reprint requests to Sang-Chul Lim, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, 8 Hack-dong, Dong-gu, Gwangju, 501-190 Korea; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD