Abstract

CerebroSpinal Fluid (CSF) rhinorrhoea takes place when there is a breakdown of all barriers that separate the nasal cavity from the subarachnoid space. Majority of the cases resolve with conservative treatment. For cases who do not respond to conservative management, require surgical correction. Endoscopic assisted transnasal repair of CSF leak has become the preferred modality of surgical treatment of CSF leak.

Methods

This was a retrospective study done in Department of Otorhinolaryngology and Head and Neck surgery, JSS Academy of higher education and Research. It included 43 cases of CSF rhinorrhoea who underwent endoscopic endonasal surgery for leak repair during the year 2014-2018. Two groups of patients were studied, group A (patients in whom Fibrin glue was used) and group B (patients in who Fibrin glue was not used). Nasal endoscopy was done to all patients during the follow up, every 2 weeks for 2 months, later every month for a minimum of 6 months.

Results

Among the 43 cases, 22 patients were male and 21 were females. Age group ranged from 27-70 years. Majority of cases were spontaneous CSF leak. Most common site of leak was cribriform plate. There was success rate of 96.1% (25/26) in group A. The success rate was 83% (15/17) in Group B. There was no statistically significant difference between the results of endoscopic closure of CSF leak with fibrin glue and without fibrin glue. (Chi square test p value- 0.31).

Conclusion

Endoscopic transnasal CSF leak repair is an excellent surgical technique for CSF rhinorrhoea. Spontaneous CSF rhinorrhoea is more common than traumatic CSF rhinorrhoea. There was no statistically significant difference in results of CSF leak repair with fibrin glue and without fibrin glue.