Endoscopic repair of cerebrospinal fluid rhinorrhea: Learning from our failures

Endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea is becoming a com mon procedure. The purpose of this study was to perform a literature analys is centering cases of treatment failure and to review our 31 cases with a 1 -year minimum follow-up. An extensive search of the literature was conducte d, which focused on success rate, follow-up, diagnostic techniques, graft m aterial used, failure rate, and comments on failures. A retrospective analy sis of our 31 patients was carried out, and all cases were treated with the endoscopic approach with a 1-year minimum follow-up. From the literature a nalysis, the median success rate at the first endoscopic attempt is 90%. Ou r success rate was 87.1%. Failures were analyzed. A unique protocol for CSF leak diagnosis does not exist; we suggest our diagnostic algorithm. Graft material used depends on the authors' experience, and based on this review of cases to date, did not significantly, influence the success rate. The an alysis of cases of failure shows that the majority of authors omit details. More research is needed to improve prevention of failures.