Outcomes and Complications of Endoscopic Endonasal Repair for Spontaneous CSF Rhinorrhea: A Four-Year Experience of 85 Cases

Objective

This study evaluated outcomes of an endoscopic endonasal multilayer repair protocol for spontaneous CSF rhinorrhea at two major tertiary centers in Khyber Pakhtunkhwa, Pakistan. Materials & Methods: This retrospective descriptive case series included 85 patients with spontaneous CSF rhinorrhea who underwent endoscopic endonasal multilayer repair over four years at two tertiary hospitals in KP, Pakistan. Diagnosis was confirmed by clinical evaluation, CSF analysis, and prone-position contrast MRI, supplemented by CT. Repair was defect-size-based: nasoseptal flap for 1-2 cm/high-flow defects (31.8%), middle turbinate flap for 7-10 mm/moderate-flow defects (35.3%), and fascia lata/fat graft for 3-6 mm/low-flow defects (32.9%). Fibrin glue was used selectively in high-risk cases; lumbar drains were used for high-flow leaks.