Abstract
Objective Cerebrospinal fluid (CSF) leaks from the frontoethmoid and sphenoid region can be
easily dealt with endoscopic approaches, but CSF rhinorrhea due to frontal sinus fractures
are difficult to treat solely by the nasal endoscopic approach and may require external
repair. The technique described targets defects of the posterior table of the frontal
sinus where conventional osteoplastic approach of obliteration is usually done. This
technique is minimally invasive and involves repair using an endoscope via a frontal
trephine.
Methods We have treated five cases of traumatic CSF rhinorrhea with this technique, and the
mean follow-up is 1 year (range: 10–14 months). The frontal sinus is opened by making
a small stab incision (frontal trephine), and the defect site is localized by visualization
via endoscope through the trephine. The repair is then performed with fat, bone graft,
and fibrin glue.
Results Closure of the defect was achieved in a single stage in all the patients, and none
of them had a recurrence of leak in the 1-year follow-up period.
Conclusion This is a good technique for superiorly and laterally placed posterior table defects
of the frontal sinus with minimal morbidity and excellent closure rates.
Keywords
CSF rhinorrhea - frontal sinus - posterior table fracture - endoscopic repair - frontal
trephine
