Commentary

This article reviewed the endoscopic management of cerebrospinal fluid (CSF) leaks, a technique that has been used since the 1980s. The authors treated nine cases over 3 years and had good results in eight of the nine cases after the original operation.

This technique is well known to otolaryngologists. At many hospitals, it is the first-line treatment offered for a CSF leak from the skull base judged to be reachable with an endoscope. It is reasonable to use the technique, rather than intracranial or transcranial approaches (which can be held as back-ups for endoscopic failure), to deal with the problem. The technique is advantageous because of its ease of access. In fact, it is an extracranial procedure and is performed on an outpatient basis with local anesthesia and intravenous sedation. In experienced hands, the morbidity rate is minimal.