Recurrent spontaneous CSF rhinorrhea: combined endo-nasal endoscopic repair with lumbo-peritoneal shunt insertion

Abstract Background Spontaneous cerebrospinal fluid (CSF) leaks are associated with high morbidity and recurrence rates. Most cases had increased intracranial pressure (ICP) on presentation. There is still controversy regarding the use of lumbo-peritoneal shunt to prevent its recurrence. Aim This study was conducted evaluate impact CSF following initial as well recurrent repair spontaneous avoid Methods A retrospective cohort reviewed patients over a 4-year period. All ICP were subjected endoscopic procedure. Results Eighteen included in this study. obese (BMI = 33.6 ± 1.8 kg/m 2 ) women (88.9%), sleep apnea syndrome (77.8%). presented headache visual complaints. Meningitis recorded two (11.1%). The most common sites leakage cribriform (66.7%), followed by both ethmoidal (16.7%), sphenoid (11.1%), (5.6%) bones. mean defect size 5.1 1.1 mm. About one third multiple defects. Encephalocele meningocele encountered 61.1% 66.7% cases, respectively. preoperative 36.5 1.7 mm H O. Lumbo-peritoneal inserted for all our patients. failure rate 11.1%. Conclusion Success higher hypertension treated shunt. Future prospective studies larger sample sizes should confirm efficacy safety management plan.