Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management

Mehmet Kaya; Yunus Emre Topan

doi:10.65396/ejra.1906261

Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management

Abstract

Cerebrospinal fluid (CSF) leak remains one of the most serious complications of endoscopic sinus surgery (ESS). Although rare, its consequences may include meningitis, pneumocephalus, intracranial abscess, and long-term neurological morbidity. This expanded manuscript presents a comprehensive academic review of preventive strategies, surgical techniques, anatomical considerations, and postoperative management regarding CSF leaks in ESS. Among the critical intraoperative hazards, catastrophic orbital hemorrhage and CSF leak represent the two complications most universally dreaded by rhinologic surgeons. Both events underscore the necessity of meticulous preoperative planning, high-resolution CT evaluation, and disciplined intranasal dissection that respects natural boundaries. Although the majority of ESS procedures proceed uneventfully, even small breaches in the skull base may lead to CSF rhinorrhea, with potential sequelae including meningitis, intracranial abscess, pneumocephalus, prolonged hospitalization, and the need for revision surgery. Early intraoperative recognition—such as identifying clear pulsatile fluid, the reservoir sign, or sudden visualization of dura—is essential, as timely repair can prevent both acute morbidity and delayed complications. The purpose of this work is to provide surgeons with a clear, structured framework to minimize risk and to optimize outcomes through evidence-based repair protocols.

Keywords

Supporting Institution

N/A

Ethical Statement

Present

References

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Details

Primary Language

English

Subjects

Otorhinolaryngology

Journal Section

Research Article

Authors

Mehmet Kaya
0000-0002-0428-4763
Türkiye

Yunus Emre Topan ^*
Türkiye

Publication Date

March 26, 2026

Submission Date

March 10, 2026

Acceptance Date

March 14, 2026

Published in Issue

Year 2026 Volume: 9 Number: 1

DOI

https://doi.org/10.65396/ejra.1906261

IZ

https://izlik.org/JA74HY62SB

Cite

RIS / Bibtex

APA

Kaya, M., & Topan, Y. E. (2026). Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management. European Journal of Rhinology and Allergy, 9(1), 52-57. https://doi.org/10.65396/ejra.1906261

AMA

1.Kaya M, Topan YE. Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management. Eur J Rhinol Allergy. 2026;9(1):52-57. doi:10.65396/ejra.1906261

Chicago

Kaya, Mehmet, and Yunus Emre Topan. 2026. “Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management”. European Journal of Rhinology and Allergy 9 (1): 52-57. https://doi.org/10.65396/ejra.1906261.

EndNote

Kaya M, Topan YE (March 1, 2026) Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management. European Journal of Rhinology and Allergy 9 1 52–57.

IEEE

[1]M. Kaya and Y. E. Topan, “Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management”, Eur J Rhinol Allergy, vol. 9, no. 1, pp. 52–57, Mar. 2026, doi: 10.65396/ejra.1906261.

ISNAD

Kaya, Mehmet - Topan, Yunus Emre. “Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management”. European Journal of Rhinology and Allergy 9/1 (March 1, 2026): 52-57. https://doi.org/10.65396/ejra.1906261.

JAMA

1.Kaya M, Topan YE. Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management. Eur J Rhinol Allergy. 2026;9:52–57.

MLA

Kaya, Mehmet, and Yunus Emre Topan. “Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management”. European Journal of Rhinology and Allergy, vol. 9, no. 1, Mar. 2026, pp. 52-57, doi:10.65396/ejra.1906261.

Vancouver

1.Mehmet Kaya, Yunus Emre Topan. Cerebrospinal Fluid Leakage in Endoscopic Sinus Surgery: Prevention and Management. Eur J Rhinol Allergy. 2026 Mar. 1;9(1):52-7. doi:10.65396/ejra.1906261