CSF Rhinorrhea Repair (Endoscopic Transnasal Surgery)
Cerebrospinal Fluid (CSF) Rhinorrhea is a condition in which the clear, watery fluid that surrounds and cushions the brain and spinal cord leaks through the nose. This fluid plays a vital role in protecting the brain, maintaining pressure balance, and removing waste products. When a leak develops, it not only disrupts this delicate balance but also exposes the brain to a serious risk of infection such as meningitis.
CSF leaks most commonly occur due to trauma, previous sinus or skull base surgeries, congenital skull base defects, or spontaneous thinning of the skull bone separating the brain from the nasal cavity. Patients often mistake the leakage for a persistent runny nose or sinus issue, but CSF rhinorrhea is a medical emergency that requires expert neurosurgical evaluation.
Dr. Rahul Gupta, Director of Neurosurgery at Fortis Noida, has extensive experience in the diagnosis and endoscopic repair of skull base defects leading to CSF leaks. Using endoscopic transnasal repair techniques, Dr. Gupta provides a minimally invasive yet highly effective solution that eliminates the need for large incisions, minimizes complications, and ensures a fast recovery. His precision and deep anatomical understanding make him one of the leading experts in managing skull base conditions with excellent long-term outcomes.
Clinical Management
The cornerstone of managing CSF rhinorrhea is accurate localization of the leak site. Diagnosis begins with a detailed clinical history and specialized imaging tests such as CT cisternography or MRI of the skull base, which identify the exact point of the defect. Laboratory testing of the nasal discharge for beta-2 transferrin helps confirm that the fluid is indeed cerebrospinal in origin.
Once the diagnosis is established, endoscopic transnasal repair is the preferred surgical approach. This modern technique allows direct access to the leak site through the nostrils, avoiding any external incision or brain retraction. Using a high-definition endoscope, Dr. Rahul Gupta carefully identifies the defect and seals it using biological grafts or fascia, sometimes reinforced with synthetic materials. Advanced neuronavigation and fluorescence imaging may also be used to ensure precision.
Compared to older open surgical methods, the endoscopic approach results in minimal bleeding, less postoperative pain, and faster recovery. Most patients are discharged within a few days and are advised to avoid straining, nose blowing, or heavy lifting for a short period to allow proper healing of the graft.
Postoperatively, regular follow-up with imaging and nasal endoscopy ensures the closure remains intact and no infection develops. In Dr. Gupta’s care, patients benefit from a multidisciplinary approach that includes ENT specialists, neurologists, and infectious disease experts to ensure a comprehensive, safe recovery.
The success rate of endoscopic CSF leak repair under Dr. Rahul Gupta’s expertise exceeds international standards, with most patients experiencing complete resolution after the first procedure. By combining advanced technology with a patient-focused approach, Dr. Gupta continues to set a high benchmark in skull base and endoscopic neurosurgery.