Facial plast Surg 2009; 25(1): 029-037
DOI: 10.1055/s-0028-1112229
© Thieme Medical Publishers

Endoscopic Management of Cerebrospinal Fluid Leaks

J. Drew Sanderson1 , Stilianos E. Kountakis2 , K. Christopher McMains1
  • 1University of Texas Health Science Center at San Antonio, San Antonio, Texas
  • 2Medical College of Georgia, Augusta, Georgia
Further Information

Publication History

Publication Date:
10 February 2009 (online)


Cerebrospinal fluid (CSF) rhinorrhea is an uncommon but important medical condition. It can result from trauma, intracranial hypertension, or be idiopathic in origin. If left untreated, significant sequelae can result including infectious meningitis. Beta-2 transferrin is a sensitive and specific protein marker for CSF. Various radiographic modalities have been used to localize defects, including computed tomography (CT), magnetic resonance imaging, and CT cisternography. In recent years, surgical management of this condition has evolved significantly, primarily being performed endoscopically. Reconstruction can be performed with fat, free mucosal, or fascial grafts, or with vascularized flaps. The endoscopic surgeon should have a thorough understanding of the pathophysiology and diagnosis of CSF rhinorrhea as well as several surgical options in his or her armamentarium available to treat the patient suffering from CSF rhinorrhea.