Repair of Cerebrospinal Fluid Leak and Encephalocele of the Cribriform Plate

Cerebrospinal fluid (CSF) leaks from the nose, and sinuses are infrequent problems that require skilled techniques to manage. Whether iatrogenic or spontaneous, CSF leaks occurring in the cribriform area of the ethmoid sinuses are aptly suited for minimally invasive and endoscopic repair. While CSF leaks were in the past solely within the purview of the neurosurgeon, these defects can be approached via a transnasal endoscopic route and typically repaired using a variety of reconstructive techniques––many of them including grafts harvested from within the nasal cavity or sinuses––by an otolaryngologist. Today, endoscopic repair of cribriform CSF leaks is the mainstay of surgical repair, and this technique enjoys a very high success rate with few complications, recurrence rates, and morbidity.