{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:01:33Z","timestamp":1770883293317,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T00:00:00Z","timestamp":1663459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Spontaneous cerebrospinal fluid (CSF) leaks (SCSFL) occur in the absence of trauma, surgery, or underlying intracranial pathology. They represent a significant healthcare burden on patients with complications such as meningitis. We present our experience of SCSFL repair via the endonasal endoscopic approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent CSF fistula repair at a tertiary UK hospital, between 1st January 2012 to 31st December 2019, were identified and had their case notes analyzed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 33 patients included consisting of 27 (81.8%) females, with age range from 31 to 81\u2009years (mean 55.2). Mean body mass index (BMI) was 35.2\u00a0kg\/m<jats:sup>2<\/jats:sup>, with 32 (97.0%) patients overweight (BMI &gt;25). All patients presented with intermittent watery rhinorrhoea and had a positive biochemical analysis. Computed tomography (CT) and\/or magnetic resonance imaging (MRI) identified leak sites in 29 patients (87.9%). The most common intraoperative defect site was the cribriform plate (42.4%). A variety of closing techniques were used including onlay grafts (72.7%), tissue glue (87.9%), nasoseptal flaps (63.6%), mucosal free grafts (21.2%), fat grafts (21.2%), and additional support materials (87.9%). Nasal packing was used in all patients. The average length of stay was 1.6\u2009days. Postoperative complications occurred in two patients (6.1%) (meningitis, epistaxis). Overall, there was a successful primary repair in 32 (97.0%) patients with most cases employing a multilayered reconstruction method (78.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results demonstrate excellent success rates with the endoscopic endonasal approach to SCSFL. This adds to the literature by demonstrating a detailed analysis of the experience in SCSFL management in one of the largest UK centres.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ases.13125","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T01:29:57Z","timestamp":1663550997000},"page":"68-76","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Endonasal endoscopic management of spontaneous cerebrospinal fluid rhinorrhoea: The Birmingham <scp>UK<\/scp> experience"],"prefix":"10.1111","volume":"16","author":[{"given":"Karan","family":"Jolly","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, New Cross Hospital The Royal Wolverhampton NHS Trust  Wolverhampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-0001","authenticated-orcid":false,"given":"Keshav Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, New Cross Hospital The Royal Wolverhampton NHS Trust  Wolverhampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navdeep","family":"Bhamra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, New Cross Hospital The Royal Wolverhampton NHS Trust  Wolverhampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Aslanidou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruchika","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahzada K.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust  Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6413-x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.19.2286"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.6.JNS09415"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0000000000000761"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.12.1713"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001141"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-009-9008-x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05570-x"},{"key":"e_1_2_8_10_1","first-page":"1","article-title":"Surgical outcomes of the endonasal endoscopic approach within a standardized management protocol for repair of spontaneous cerebrospinal fluid rhinorrhea","volume":"1","author":"Kreatsoulas DC","year":"2020","journal-title":"J Neurosurg"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","unstructured":"Perez\u2010VegaC Robles\u2010LomelinP Robles\u2010LomelinI Garcia NavarroV. 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