Safety and efficacy of endoscopic repair of CSF leaks and encephaloceles: A survey of the members of the American Rhinologic Society

The purpose of this article is to review the endoscopic management of cereb rospinal fluid (CSF) leaks and encephaloceles, with particular emphasis on safety and efficacy, by retrospective assessment utilizing the results of a mailed questionnaire. Surveys were mailed to members of the American Rhino logic Society with practices in both academic centers and/or private settin gs. Survey results were then assessed and tabulated. There were 635 mailing s, with 197 responses (31%). Seventy-two (36% of respondents) indicated tha t they performed endoscopic management of CSF leaks and encephaloceles, whi le 125 (64% of respondents) did not. Respondents reported similar to 522 ca ses of CSF leaks and similar to 128 cases of encephaloceles managed by endo scopy. Success rates after a single procedure were estimated at 90% for CSF leaks and 93% for encephaloceles. Success rates after a secondary procedur e were estimated at 86% and 97%, respectively; 29% of respondents have, at some point, made a referral to neurosurgery. A total of 13 complications re lated to endoscopic repairs were reported (2.5%). For CSF leak repair compl ications included seizures, 0.2%; meningitis, 1.1%; and one reported case e ach of cavernous sinus thrombosis, temporary visual problems, sinusitis, an d intracranial hypertension/bleed. There was only one reported death in the similar to 522 cases. Eleven complications following encephalocele repairs (8.5%) included seizures, 3.1%; meningitis, 2.3%; and one reported case ea ch of brain abscess, sinusitis, false aneurysm of middle cerebral artery, a nd mild dizziness. No deaths following encephalocele repair were reported T he endoscopic management of CSF leaks and encephaloceles has become increas ingly popular and has proven to have low morbidity and mortality with high success. Overall, our results confirm that in the hands of the skilled endo scopist, endoscopic management of CSF leaks and encephaloceles is highly ef ficacious and has a very low incidence of significant complication.