Ethmoid CSF Cerebrospinal Fluid Leak

Abstract

Endoscopic sinus surgery (ESS) is an excellent option for addressing medically recalcitrant sinus disease. The combination of stereotactic image-guided navigation and advances in surgical techniques have transformed the procedure, allowing surgeons to perform more thorough dissection while minimizing risks. Despite these advances, iatrogenic injury during ESS accounts for 16% of anterior skull base cerebrospinal fluid (CSF) leaks, with the most common location involving the cribriform plate. In this chapter, we will discuss key aspects to consider in order to avoid injury to the skull base as well as highlight the proper steps to take if a CSF leak should occur.