State of the art cerebrospinal fluid leak and encephalocele repair

The advent of endoscopic sinus surgery has revolutionized the treatment of cerebrospinal fluid (CSF) leaks. Defects traditionally treated with an open approach have now been successfully repaired using either an endoscopic or combined endoscopic/open approach. This process has resulted in decreased operative morbidity and shorter lengths of stay. Various approaches will be described to treat CSF leaks based on their location within the sinonasal cavity. This article is designed to describe the techniques of endoscopic repair of CSF leaks and determine when an open approach will be needed, either as an adjunctive procedure or as the sole treatment of a CSF leak. When appropriate, schematic illustrations have been included to facilitate reader understanding and orientation.