CSF Leak — CT Cisternography and Surgical Repair

Diagnosis and endoscopic closure of cerebrospinal fluid rhinorrhea and otorrhea

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 17, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is CSF Leak — CT Cisternography and Surgical Repair?

Cerebrospinal fluid (CSF) leak occurs when a defect in the dura and skull base allows fluid to drain through the nose or ear, raising the risk of bacterial meningitis. Causes include trauma, prior surgery, tumors, and spontaneous high-pressure leaks.

CT cisternography after intrathecal contrast injection demonstrates the precise location of the bony defect, while beta-2 transferrin testing confirms the fluid as CSF. MR cisternography helps for active flow visualization.

Endoscopic endonasal multilayer repair using fascia, fat, and mucosal flaps closes the leak with success rates above 90 percent. Postoperative lumbar drainage and intracranial pressure management are essential for high-flow leaks.

Symptoms

Clear watery nasal drainage

Salty taste in throat

Positional headache

Recurrent meningitis

Clear ear drainage

Risk Factors

Skull base trauma

Prior endoscopic sinus surgery

Skull base tumor or surgery

Idiopathic intracranial hypertension

Congenital skull base defect

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

For persistent unilateral clear nasal discharge
For unexplained recurrent meningitis
For positional headache with rhinorrhea
After head trauma with nasal drainage
For postoperative CSF leak

Treatment Methods

CT cisternography for localization

Beta-2 transferrin confirmation

Conservative bed rest and lumbar drainage

Endoscopic endonasal multilayer repair

Skull base reconstruction with grafts

Postoperative ICP management

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book Appointment Contact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.