Factors Affecting Success Rates in Endoscopic Repair of CSF Rhinorrhea

Sisli Etfal Hastan Tip Bul. 2024 Apr 5;58(1):17-22. doi: 10.14744/SEMB.2023.35589. eCollection 2024.

Abstract

Objectives: Our aim in this study is to assess the effect of factors such as age, etiology, defect size, application of lumbar drainage and surgical technique on Cerebrospinal Fluid (CSF) fistula repair success rates.

Methods: The Electronic Medical Records (EMR) system of our clinic was retrospectively reviewed for cases that were operated between 2006 and 2020 for CSF fistula originating from anterior skull base with endoscopic transnasal technique. A total of 35 patients were included in the study. Patients were grouped according to the number of layers used in repair (two, three or four-layered reconstruction) and defect size (smaller than 5 mm, 5 to 10 mm and larger than 10mm), etiology, location of the defect and application of lumbar drainage as LD (+) and LD (-). Complications and CSF leak recurrence were compared between groups.

Results: Recurrence rates in patients who had 2 layered reconstructions were significantly higher compared to patients who had 3 or 4 layered reconstructions (p=0.049). The recurrence rate in LD (+) group (41.7%) was significantly lower compared to LD (-) group (4.3%) (p=0.012). There were no significant difference in recurrence rates between groups in terms of age, defect size, defect location and etiology.

Conclusion: In endoscopic transnasal repair of anterior skull base-derived bos fistulas, planning the reconstruction at least 3 times and applying lumbar CSF drainage increases the success rates.

Keywords: Cerebrospinal fluid fistula; cerebrospinal fluid leak; endoscopic surgery; rhinorrhea.