Commentary “Transnasal Transsphenoidal Endoscopic Repair of CSF Leakage Using Multilayer Acellular Dermis”

The authors present 21 patients who underwent transnasal/transsphenoidal endoscopic repair of CSF leaks using acellular dermis. They successfully closed the defect with one operation in 19 patients. Two other patients required a second repair. These two failures occurred in patients with hydrocephalus who then underwent another endoscopic transsphenoidal procedure and placement of a VP shunt, which resolved their CSF leakage. The authors' excellent results are encouraging and show that acellular dermis is useful for closure and can be accomplished endoscopically.