Endoscopic transorbital approach for repair of spontaneous CSF leak and frontal sinus encephalocele

CSF leaks due to anterior skull base defects, particularly those involving the posterior wall of the frontal sinus, are complex and often require surgical intervention. The endoscopic transorbital approach provides a direct, minimally invasive method with enhanced access and improved working angles. The authors present a video of a 41-year-old female with a spontaneous CSF leak and frontal sinus encephalocele who underwent endoscopic transorbital repair. This approach effectively controlled the defect, resulting in the resolution of the CSF leak with no recurrence at 1-year follow-up. The endoscopic transorbital approach is a reliable surgical option for these challenging cases. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24153.