A frontal sinus leak is uncommon and is seen in ∼15% of patients with CSF rhinorrhea. Endonasal endoscopic techniques have been reported to reconstruct skull base defects in the frontal sinus with a favorable outcome.

Researchers conducted this study to review our experience in repairing frontal sinus CSF leaks through an endonasal endoscopic approach.

Twenty-four patients with a frontal sinus leak who underwent endonasal endoscopic repair entered the study. Clinical presentation, location, frontal sinusotomy, graft material, follow-up, and frontal sinus status were evaluated.

Among >100 cases of surgically repaired CST rhinorrhea, the frontal sinus was the leak in 24 patients. The etiology consisted of the spontaneous leak and traumatic leak, whereas patients with skull base reconstruction after removing the tumor were excluded. Surgical approaches included Draf IIb, Draf III, Draf IIa in 20, 3, and 1 patient. Tree autografts as two-layer inlay fat–muscle and only fascia lata were used in most patients. A success rate was achieved in 95.83% of the patients.

The study concluded that Endonasal endoscopic repair of a frontal sinus leak was a successful procedure, with a low failure rate and minimal morbidity.

Reference: https://journals.sagepub.com/doi/full/10.2500/ajra.2017.31.4478