Endoscopic Management Of Cerebrospinal Fluid Rhinorrhea And Surgical Considerations

Objective To study the technique of intranasal endoscopic surgery forrepairing of cerebrospinal fluid(CSF) rhinorrhea and evaluate the therapeutic effect, inorder to summarize our clinical experience in managing CSF rhinorrhea.Methods11cases of CSF rhinorrhea underwent treatment in our departmentfrom August2006to April2012were reviewed. Among all the cases,5weretraumatic and6were spontaneous CSF rhinorrhea,2cases among the latter were withempty sella syndrome(ESS).2cases of traumatic CSF rhinorrhea underwentconservative treatment, the left9cases including3traumatic and6spontaneous CSFrhinorrhea underwent intranasal endoscopic surgery.Results2cases of traumatic CSF rhinorrhea underwent conservative treatmentwere cured taking a mean period of6days. The sites of the lesions of9casesunderwent intranasal endoscopic surgery located:5at the superior wall of posteriorethmoid cells,1at olfactory cleft,1at the lateral wall of anterior part of sphenoidsinus and1at conjunction part of lateral and superior wall of sphenoid sinus.1casesuffered from purulent meningitis after surgery and the left8cases had nocomplication. Cases were followed up for6months to5years after surgery and foundno recurrence, all9cases were successfully repaired during one attempt.Conclusions Intranasal endoscopic surgery for repairing of cerebrospinalfluid(CSF) rhinorrhea is a safe, micro-invasive and effective method, it is now thefirst choice of surgery for CSF rhinorrhea cases. The rigid mastering of surgeryindications, accurate finding and proper managing of lesion sites are key factors forthe success of surgery. Measures should be done to prevent and control thecomplications of the surgery.