Endoscopic repair of cerebrospinal fluid rhinorrhea

Endoscopic repair of cerebrospinal fluid rhinorrhea is a promising alternat ive to traditional repair techniques. This article reports our experience w ith 21 cases (10 spontaneous, 8 iatrogenic, and 3 traumatic). Various diagn ostic radiographic modalities were used, including computer-aided technique s. Most repairs were accomplished with a free fascial graft positioned in t he epidural space. Postoperative lumbar drainage was used in 15 cases. Init ial repair was successful in 18 cases (85.7%). In all 3 failures, the surge on had difficulty with proper graft placement. Additionally, 2 of these cas es were confounded by early inadvertent removal of the lumbar drain. All pa tients in whom the procedure failed underwent a second successful endoscopi c repair. There were no major complications. In our experience endoscopic r epair of cerebrospinal fluid rhinorrhea is a safe and effective approach th at can be improved with computer-aided localization devices. Proper graft p lacement is critical, and lumbar drainage is an important adjunct in select ed cases.