CSF leak is a serious c ondition caused by an abnormal communication between the subarachnoid spac e and the nasal cavity or paranasal sinuses. It may result from traumatic injuries\, surgical complications\, tumors\, or spontaneous skull base def ects. If not diagnosed and managed properly\, CSF leaks can lead to life-t hreatening complications such as bacterial meningitis and recurrent infect ions. Prompt identification and appropriate repair are critical to prevent these adverse outcomes
With ad vances in endoscopic techniques\, the management of CSF leaks has shifted from open cranial procedures to minimally invasive endonasal approaches. E ndoscopic skull base surgery offers improved visualization\, reduced morbi dity\, shorter hospital stays\, and excellent cosmetic results compared to traditional transcranial methods. It has become the gold standard for mos t anterior and middle skull base CSF leak repairs.
The primary objective of this presentation is to provi de a comprehensive overview of the endoscopic management of CSF leaks. The lecture will cover the common etiologies of CSF leaks—including traumat ic\, iatrogenic\, and spontaneous cases—and the clinical signs such as c lear rhinorrhea\, positional headache\, and recurrent meningitis. The impo rtance of a thorough diagnostic workup will be emphasized\, particularly t he role of beta-2 transferrin testing\, high-resolution CT scans\, MRI\, a nd CT cisternography. Intrathecal fluorescein may also be discussed as a v aluable tool for intraoperative localization of the leak site
Surgical indications will be clearly define d\, with a focus on factors such as the size and location\, flow rate of t he leak\, and associated anatomical variations. Step-by-step surgical tech niques will be demonstrated\, including debridement\, identification of th e defect\, and closure using various grafting materials such as fat\, fasc ia lata\, and synthetic dural substitutes. The use of multilayer repair st rategies will be highlighted for high-flow or large defects
Intraoperative tools\, including angled endos copes\, image-guided navigation\, and micro-instruments\, significantly en hance surgical precision
Partic ipants will gain insight into the management of complex or recurrent leaks \, complications such as pneumocephalus and infection\, and long-term foll ow-up protocols. Success rates for endoscopic repair are generally high\, with over 90% success reported in experienced hands
This session targets ENT surgeons\, neurosurgeons\, r hinologists\, residents\, and skull base surgery teams. It aims to equip a ttendees with practical knowledge and surgical strategies for effective\, safe\, and long-lasting management of CSF leaks through endoscopic techniq ues
In conclusion\, endoscopic repair of CSF leaks is a safe and highly effective technique that has beco me the preferred method for most skull base defects. A multidisciplinary a pproach\, careful patient selection\, and adherence to surgical principles are key to achieving optimal outcomes and preventing recurrence. CSF leak is a serious condition caused by an abnormal communication between the su barachnoid space and the nasal cavity or paranasal sinuses. It may result from traumatic injuries\, surgical complications\, tumors\, or spontaneous skull base defects. If not diagnosed and managed properly\, CSF leaks can lead to life-threatening complications such as bacterial meningitis and r ecurrent infections. Prompt identification and appropriate repair are crit ical to prevent these adverse outcomes.
DTSTAMP:20260805T041707Z LOCATION:Rhinology 3 (HILTON-Connie 1) SUMMARY:Endoscopic Repair of CSF Leak: A Minimally Invasive Skull Base Appr oach - Mohammadsadegh Zabihidan URL:https://sciencenext.org/ifos2026/talk/NWZZ8T/ END:VEVENT END:VCALENDAR