1887
Volume 2026, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

To evaluate the surgical outcomes, complications, and grafting strategies in patients undergoing endoscopic endonasal repair of spontaneous cerebrospinal fluid rhinorrhea (sCSFr) at a tertiary center in Qatar.

A retrospective cohort study.

A tertiary care academic hospital in Qatar.

Adult patients (≥18 years) treated for sCSFr between January 2015 and April 2025 were retrospectively reviewed. Diagnosis was confirmed using β2-transferrin testing and/or radiological imaging. All patients underwent endoscopic endonasal repair with a standardized multilayer technique using a Haddad nasoseptal flap, reinforced with autologous fat and fascia. Intraoperative lumbar drains were placed according to institutional protocol. Outcome measures included leak site, timing of diagnosis and repair, complications, and length of hospital stay.

Eighteen patients were included. The cribriform plate was the most frequently identified defect site. Eleven patients underwent surgical repair within one week of diagnosis. Three patients had a prior history of meningitis. Postoperative complications were limited: one patient developed meningitis, and one experienced a recurrence; both were successfully managed. The median hospital stay was 12 days. Lumbar drains were removed within 4–9 days, and one patient subsequently required a lumboperitoneal shunt. No graft failures were reported.

Endoscopic endonasal repair of sCSFr demonstrated favorable outcomes comparable to international standards. The procedure was associated with low rates of complications and recurrence. Routine use of lumbar drainage was well tolerated, although selective application in high-flow leaks may further optimize patient care. Further investigation is warranted regarding the use of synthetic dural substitutes, such as ReDura®.

© 2026 Msheik, Illeyan, El Mohamad, Al Duhirat, Shaikh, Paksoy, et al., licensee HBKU Press.
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References

  1. Baiano C , Somma T , Franca RA , Di Costanzo M , Scala MR , Cretella P , et al. Evolution in endoscopic endonasal approach for the management of hypothalamic-pituitary region metastasis: A single-institution experience. Front Oncol. 2022 Jul 28; 12:975738. https://doi.org/10.3389/fonc.2022.975738
     [Google الباحث العلمي]
  2. Banks CA , Palmer JN , Chiu AG , O’Malley Jr BW , Woodworth BA , Kennedy DW , et al. Endoscopic closure of CSF rhinorrhea: 193 cases over 21 years. Otolaryngol Head Neck Surg. 2009 Jun; 140:(6): 826–33. https://doi.org/10.1016/j.otohns.2008.12.060
     [Google الباحث العلمي]
  3. Chen GY , Ma L , Xu ML , Zhang JN , He ZD , Yan He C , et al. Spontaneous cerebrospinal fluid rhinorrhea: A case report and analysis. Medicine (Baltimore). 2018 Feb; 97:(5):e9758. https://doi.org/10.1097/MD.0000000000009758
     [Google الباحث العلمي]
  4. Eide JG , Mason W , Mackie H , Cook B , Ray A , Asmaro K , et al. Diagnostic accuracy of beta-2 transferrin gel electrophoresis for detecting cerebrospinal fluid rhinorrhea. Laryngoscope. 2025 Jan; 135:(1):94–6. https://doi.org/10.1002/lary.31845
     [Google الباحث العلمي]
  5. Hoffman O , Weber RJ . Pathophysiology and treatment of bacterial meningitis. Ther Adv Neurol Disord. 2009 Nov; 2:(6):1–7. https://doi.org/10.1177/1756285609337975
     [Google الباحث العلمي]
  6. Kazim M , Iqbal J , Arshad M , Abu-Dayeh AS , Albozom I , Alyafei A , et al. Extensive foreign body reaction to synthetic dural replacement after decompressive craniectomy with radiological and histopathology evidence: Observational case series. World Neurosurg. 2023; 172:e585–92. https://doi.org/10.1016/j.wneu.2023.01.089
     [Google الباحث العلمي]
  7. O’Leary S , Gowda P , Prabhakar A , Jenkins A , Darko K , Azam F , et al. Evidence-based approaches to cranial cerebrospinal fluid leaks in low- and middle-income countries: A systematic review of the literature. Neurosurg Rev. 2024 Dec 30; 48:(1):14. https://doi.org/10.1007/s10143-024-03162-w.
     [Google الباحث العلمي]
  8. Ramakrishnan N , Roy R , Singh S , Goyal S , Gupta DK , Chugh R , et al. Approach to management of cerebrospinal fluid rhinorrhea: Institutional based protocol. Indian J Otolaryngol Head Neck Surg. 2022 Oct; 74:(Suppl 2):737–44. https://doi.org/10.1007/s12070-019-01728-5
     [Google الباحث العلمي]
  9. Raza SM , Lee HY . Endoscopic approaches for spontaneous cerebrospinal fluid leaks: Review of clinical outcomes and recurrence rates. Laryngoscope Investig Otolaryngol. 2019; 4:(3):283–90. https://doi.org/10.1002/lio2.291
     [Google الباحث العلمي]
  10. El Tarabishi MN , Rabie HM , Youssef TA , El-Sharnouby MM , Fawaz SA ., Nada IM , et al. The transnasal endoscopic management of spontaneous cerebrospinal fluid rhinorrhea from the lateral recess of the sphenoid sinus. Egypt J Otolaryngol. 2016; 32:13–20. https://doi.org/10.4103/1012-5574.175797
     [Google الباحث العلمي]
  11. Ajlan A , Achrol A , Soudry E , Hwang PH , Harsh G . Spontaneous sphenoid wing meningoencephaloceles with lateral sphenoid sinus extension: The endoscopic transpterygoid approach. J Neurol Surg B Skull Base. 2014 Oct; 75:(5):314–23. https://doi.org/10.1055/s-0034-1372465
     [Google الباحث العلمي]
  12. Yadav YR , Parihar V , Janakiram N , Pande S , Bajaj J , Namdev H , et al. Endoscopic management of cerebrospinal fluid rhinorrhea. Asian J Neurosurg. 2016 Jul-Sep; 11:(3):183–93. https://doi.org/10.4103/1793-5482.145101
     [Google الباحث العلمي]
  13. Zahedi FD , Subramaniam S , Kasemsiri P , Periasamy C , Abdullah B , et al. Management of traumatic and non-traumatic cerebrospinal fluid rhinorrhea-experience from three Southeast Asian countries. Int J Environ Res Public Health. 2022 Oct 25; 19:(21):13847. https://doi.org/10.3390/ijerph192113847
     [Google الباحث العلمي]
  14. Kaplanoglu H , Kaplanoglu V , Dilli A , Toprak U , Hekimolu B . An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography. Eurasian J Med. 2013 Jun; 45:(2):115–25. https://doi.org/10.5152/eajm.2013.23
     [Google الباحث العلمي]
  15. Zwagerman NT , Wang EW , Shin SS , Chang YF , Fernandez-Miranda JC , Snyderman CH , et al. Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial. J Neurosurg. 2018 Oct 19; 131:(4): 1172–8. https://doi.org/10.3171/2018.4.JNS172447
     [Google الباحث العلمي]
  16. Conger A , Zhao F , Wang X , Eisenberg A , Griffiths C , Esposito F , et al. Evolution of the graded repair of CSF leaks and skull base defects in endonasal endoscopic tumor surgery: Trends in repair failure and meningitis rates in 509 patients. J Neurosurg. 2019 Mar 1; 130:(3):861–75. https://doi.org/10.3171/2017.11.JNS172141
     [Google الباحث العلمي]
  17. Bitner BF , Torabi SJ , Hong EM , Abello EH , Goshtasbi K , Hsu FPK , et al. Clinical characteristics and temporal trends of lumbar drain use in minimally invasive resection of pituitary neoplasms. World J Otorhinolaryngol Head Neck Surg. 2024;1–7. https://doi.org/10.1002/wjo2.229
     [Google الباحث العلمي]
  18. Chaskes MB , Barton B , Karsy M , Rabinowitz MR , Nyquist GG , Farrell C , et al. Superiorly based middle turbinate flap for repair of cerebrospinal fluid rhinorrhea: A cadaveric feasibility study and case series. J Neurol Surg B Skull Base. 2022 Oct 12; 84:(6):585–90. https://doi.org/10.1055/a-1934-9095
     [Google الباحث العلمي]
  19. Zadeh G , Saleh F . Endoscopic endonasal repair of spontaneous cerebrospinal fluid rhinorrhea: A review of outcomes. J Neurosurg. 2016; 125:(6): 1454–61. https://doi.org/10.3171/2016.1.JNS152392
     [Google الباحث العلمي]
  20. George S , Suresh S . Vascularized middle turbinate mucoperiosteal flap in skull base defects: Follow-up analysis of 20 cases. Int J Otorhinolaryngol Head Neck Surg. 2016; 3:(1):71–6. https://doi.org/10.18203/issn.2454-5929.ijohns2016478620
     [Google الباحث العلمي]
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Outcomes of endoscopic repair for spontaneous CSF rhinorrhea: A 10-year single-center review
Qatar Medical Journal 2026, 11 (٢٠٢٦); https://doi.org/10.5339/qmj.2026.11
/content/journals/10.5339/qmj.2026.11
/content/journals/10.5339/qmj.2026.11
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  • نوع المستند: Research Article
الموضوعات الرئيسية endoscopic endonasal approach, Hamad Medical Corporation, retrospective analysis, skull base repair and Spontaneous nasal CSF rhinorrhea

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