Cerebrospinal fluid rhinorrhoea is a condition in which the cerebrospinal fluid leaks through the nose due to a defect in the skull bone. Such patients usually present with a clear watery nasal discharge which increases on bending forwards. The presence of a defect predisposes such patients to infections such as meningitis, as the microorganisms can reach the brain through the defect. Some patients may present with repeated episodes of meningitis.

CT scan (A) and corresponding endoscopic image (B) showing a defect in the skull base with prolapsed meninges (red arrows)

These defects can be closed via an endonasal approach without the need for a craniotomy (which involves opening the skull) unless contraindicated. The defect is identified with the help of an endoscope and is sealed with the patient’s own tissue such as fat, cartilage or fascia (as per requirement) for which a small incision is made on the thigh or abdomen. The surgery is performed under general anesthesia. A hospital stay of about 5-6 days is required following the surgery. The morbidity following an endoscopic CSF rhinorrhoea is much less as compared to a craniotomy.