Application of endoscopic extended endonasal transsphenoidal approach for cerebrospinal fluid rhinorrhea repair in primary hospitals

Objective To evaluate the clinical value of the endoscopic expanded endonasal transsphenoidal approach for cerebrospinal fluid rhinorrhea (CSFR) repair in primary hospitals. Methods and Results A retrospective analysis was conducted on 30 patients between January 2022 and December 2023 at Togtoh County Hospital, Jungar Banner People's Hospital, and Siziwang Banner People's Hospital in Inner Mongolia Autonomous Region. All patients underwent endoscopic expanded endonasal transsphenoidal approach for CSFR repair using standardized endoscopic surgical techniques and repair materials (such as autologous fat, fascia, or synthetic materials). All procedures were successfully completed, with an average operative time of (73.00 ± 15.90) min and intraoperative blood loss of (34.00 ± 16.94) ml. The postoperative complication rate was 6.67% (2/30), including transient CSFR (one case) and mild nasal infection (one case), both of which resolved with conservative treatment. The average hospital stay was (7.43 ± 2.06) d. During an average follow⁃up period of (9.97 ± 3.51) months, recurrence occurred in 3 cases (10%), all of which were successfully cured with secondary repair, resulting in a final cure rate of 100% (30/30). Conclusions The endoscopic expanded endonasal transsphenoidal approach for CSFR repair demonstrates favorable efficacy and safety in primary hospitals, along with cost ⁃ saving benefits, making it worthy of wider adoption.