Endoscopic Repair of CSF Leak: A Minimally Invasive Skull Base Approach
09-10, 15:40–15:50 (Europe/Istanbul), Rhinology 3 (HILTON-Connie 1)

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<p>CSF leak is a serious condition caused by an abnormal communication between the subarachnoid 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 recurrent infections. Prompt identification and appropriate repair are critical to prevent these adverse outcomes</p> <p>With advances in endoscopic techniques, the management of CSF leaks has shifted from open cranial procedures to minimally invasive endonasal approaches. Endoscopic skull base surgery offers improved visualization, reduced morbidity, shorter hospital stays, and excellent cosmetic results compared to traditional transcranial methods. It has become the gold standard for most anterior and middle skull base CSF leak repairs.</p> <p>The primary objective of this presentation is to provide a comprehensive overview of the endoscopic management of CSF leaks. The lecture will cover the common etiologies of CSF leaks—including traumatic, iatrogenic, and spontaneous cases—and the clinical signs such as clear rhinorrhea, positional headache, and recurrent meningitis. The importance of a thorough diagnostic workup will be emphasized, particularly the role of beta-2 transferrin testing, high-resolution CT scans, MRI, and CT cisternography. Intrathecal fluorescein may also be discussed as a valuable tool for intraoperative localization of the leak site</p> <p>Surgical indications will be clearly defined, with a focus on factors such as the size and location, flow rate of the leak, and associated anatomical variations. Step-by-step surgical techniques will be demonstrated, including debridement, identification of the defect, and closure using various grafting materials such as fat, fascia lata, and synthetic dural substitutes. The use of multilayer repair strategies will be highlighted for high-flow or large defects</p> <p>Intraoperative tools, including angled endoscopes, image-guided navigation, and micro-instruments, significantly enhance surgical precision</p> <p>Participants will gain insight into the management of complex or recurrent leaks, complications such as pneumocephalus and infection, and long-term follow-up protocols. Success rates for endoscopic repair are generally high, with over 90% success reported in experienced hands</p> <p>This session targets ENT surgeons, neurosurgeons, rhinologists, residents, and skull base surgery teams. It aims to equip attendees with practical knowledge and surgical strategies for effective, safe, and long-lasting management of CSF leaks through endoscopic techniques</p> <p>In conclusion, endoscopic repair of CSF leaks is a safe and highly effective technique that has become the preferred method for most skull base defects. A multidisciplinary approach, 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 subarachnoid 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 recurrent infections. Prompt identification and appropriate repair are critical to prevent these adverse outcomes.</p>
<p>Featuring high-quality videos of endoscopic surgeries for the repair of cerebrospinal fluid (CSF) leaks which were done for our patients</p>
Speaker Speaker
Mohammadsadegh Zabihidan
Mohammadsadegh Zabihidan
<p>Focused Otolaryngology, Head and Neck surgeon with 2 years of</p> <p>experience performing variety of surgical procedures such as</p> <p>Endoscopic and Otologic surgeries, Head and Neck Tumors, Neck</p> <p>Dissection, Parotidectomy, thyroidectomy, and Rhinoplasty. Detail-</p> <p>oriented individual with thorough knowledge of modern surgical</p> <p>practices. Board-certified and highly experienced with complex</p> <p>cases. Committed to improving patient quality of life by carrying out</p> <p>standard surgical procedures and appropriate follow-ups.</p> <p>Awards and Honors</p> <p>Top Ranked Board-Certified Otolaryngologi</p> <p>Member of the National Elite Foundation of Iran</p> <p>Member of Europian Rhinology Society</p> <p>International Presentations</p> <p>“4th World Congress on Otology, Rhinology & Laryngology”</p> <p>held during October 17-18, 2024 at Tokyo, Japan</p>
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