Outcome of Endoscopic Repair of Cerebrospinal Fluid Rhinorrhea by Fascia Lata with and Without Nasoseptal Flap

Background: Endoscopic repair has been recognized as the gold standard treatment option for cerebrospinal fluid (CSF) leaks. Various techniques and adjunctive measures have been proposed, practiced, and studied to determine which produces the best result. Aim: This study aims to compare the outcomes of CSF leakage repair by fascia lata with and without nasoseptal flap. Methodology: A prospective comparative study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka from November 2023 to September 2024 on 42 cases presenting with CSF rhinorrhea. The subjects were selected based on inclusion and exclusion criteria. All study subjects were assessed pre-operatively by clinical examination, nasoendoscopy, imaging of the skull base, and fitness for general anesthesia. Study subjects were randomized into group A (repaired by fascia lata) and group B (repaired by fascia lata with nasoseptal flap) alternatively in the order that they present. All cases were operated by the same experienced surgeon. All cases underwent endoscopic repair of CSF leakage under general anesthesia. Study subjects were followed up at two weeks, one month, and two months of surgery and nasoendoscopy was done. All the data were recorded in a prefixed questionnaire. Chi- square test was used to compare results between the two groups. A p-value of less than 0.05 was considered significant. Results: On two months follow-up, two cases in group A and one case in group B had developed recurrence of leak. The closure rate following a single procedure was 90.5% in group A and 95.2% in group B. With a p- value 0.549, there was no statistical-significance in the repair rates with and without nasoseptal flap. Concussion: The endoscopic repair of CSF rhinorrhea by fascia lata does not give a better outcome with addition of nasoseptal flap.