Successful endoscopic repair of sphenoidal cerebrospinal fluid fistulae

Traditionally a cerebrospinal fluid (CSF) fistula was treated by the neurosurgeon via a craniotomy and dural repair. This technique was associated with significant morbidity. Over the last 2 years endoscopic repair of cerebrospinal fluid rhinorrhea has gained popularity and is associated with less morbidity and excellent success rates. Lateral sphenoidal CSF fistulae result in a defect in the skull base of the middle cranial fossa and due to their anatomical location provide the sinus surgeon a challenge in access and approach to repair. Various techniques have been described over the years. We report on the successful repair of two cases of sphenoidal CSF fistulae using the "bath-plug" technique. Both patients have remained dry with medium term follow-up.