The efficacy of endoscopic endonasal duraplasty compared to transcranial duraplasty for post-traumatic CSF rhinorrhea in terms of CSF rhinorrhea recurrence and other complications

Abstract

Objectives. To determine the efficacy of endoscopic endonasal dura repair versus transcranial dura repair for post-traumatic CSF rhinorrhoea in terms of CSF rhinorrhea recurrence and other complications. Materials and methods. A total of 92 patients (age 15-50 years, both genders) with an established diagnosis of CSF rhinorrhea following traumatic brain injury were enrolled in this prospective cohort study. Group A and Group B were formed from the patients. Group A received endoscopic endonasal duraplasty, while Group B received transcranial duraplasty. Recurrence of CSF rhinorrhea, as well as any other complications (meningitis, anosmia, hydrocephalus, and abscess), were noted and compared between the two groups one week, two weeks, and four weeks after the procedure. Results. In Group A, the mean age was 28.6 ± 9.9 SD years and in Group B it was 29.9 ± 8.6 SD years. In group A, there were 63% (n=29/46) patients who had age between 15-30 years and 37% (n=17/46) had age between 31-50 years. In group B, 52.2% (n=24/46) patients had age between 15-30 years and 47.8% (n=22/46) had age between 31-50 years. In group A, there were 82.6% (n=38/46) males and 17.4% (n=8/46) were females and in group B there were 87% (n=40/46) males and 13% (n=6/46) females. At one month follow-up, overall recurrence of rhinorrhea was observed in 17.4% (n=8/46) patients in Group A, while it was 41.3% (n=19/46) patients in Group B (P=0.012). On the other hand, overall complications were 8.7% (n=21/46) in Group A patients, while they were 45.7% (n=21/46) in Group B patients (P=0.001). Conclusions. During a one-month follow-up, patients who received endoscopic repair experienced fewer recurrences and other complications overall than patients who underwent transcranial duraplasty, and the difference was statistically significant. We advise conducting studies with a larger sample size and longer follow-up periods.