ENDOSCOPIC REPAIR OF DURA FOR POST TRAUMATIC RHINORRHEA IN NEURO SURGERY DEPARTMENT OF TERTIARY CARE HOSPITALS

Abstract

Objective: To analyze the etiology, anatomical location, and procedural management of cerebrospinal fluid (CSF) rhinorrhea, with a focus on identifying common patterns and outcomes to guide clinical and surgical decision-making.
Method: This retrospective study included 40 patients diagnosed with CSF rhinorrhea. Data on etiological factors, anatomical locations of CSF leaks, and the types of surgical interventions performed were collected and analyzed. Key variables included spontaneous and traumatic etiologies, anatomical sites such as the cribriform plate and sinuses, and procedural rates, including first-line and additional surgical interventions.
Result: Spontaneous CSF rhinorrhea was the most common cause (47.5%), followed by traumatic (17.5%) and neoplastic origins, including astrocytoma (12.5%) and meningeocele (7.5%).The cribriform plate was the most frequent site of leakage (65%), followed by the frontal sinus (22.5%), fovea ethmoidalis (7.5%), and sphenoid sinus (5%).Initial surgical interventions were successful in 32.5% of cases, while 22.5% required secondary procedures. Ventriculoperitoneal shunts were utilized in 20% of cases, with other interventions such as supraorbital frontal repairs (15%) and lumbar drainage (5%) addressing refractory cases.
Conclusion: Spontaneous CSF rhinorrhea, predominantly affecting the cribriform plate, represents the most frequent etiology, often linked to idiopathic intracranial hypertension. Traumatic and neoplastic causes highlight the necessity of precise diagnostic imaging and multidisciplinary management. The diversity of procedural approaches, including shunting and endoscopic repairs, underscores the importance of individualized treatment strategies tailored to anatomical and clinical findings. Further large-scale studies are needed to refine management protocols and improve outcomes.