Endonasal Endoscopic CSF Leak Repair: Trans-Cribriform and Transpterygoid Approach

Abstract

Background: Cerebrospinal fluid (CSF) leak which occurred in the left cribriform plate and the left lateral recess of sphenoid sinus in a middle aged woman which was idiopathic in origin. This observation aims to report a case of  endoscopic repair of the defects through the transcribriform and transpterygoid route in the same sitting.
Case Report: A 41 year old middle aged woman was referred from the department of neurosciences to the department of ENT  with a watery discharge   from the left nasal cavity and on evaluation bony defects were identified in the left cribriform plate and the left lateral recess of sphenoid with meningoencephalocele. The leak was repaired using the endoscopic transcribriform and the transpterygoid approach. The surgical procedure was uneventful.
Discusssion: Endoscopic transcribriform and transpterygoid  approaches were utilized in closing the defects. The defect in the left cribriform plate was sealed after bipolar coagulation with fat, fascia lata and tissue glue and the lateral recess of sphenoid defect was closed with fat, artificial dura, fascia lata and tissue glue and the patient recovered successfully after the procedure.