Abstract:Objective To assess the outcomes associated with the fat bath-plug to endoscopically repair cerebrospinal fluid (CSF) leaks in children. Methods All patients, who underwent endoscopic repair of CSF leaks utilizing abdominal free fat from September 2016 to September 2019, were included for retrospective chart review. There were 10 boys and 6 girls, aged from 5 to 123 months with a median age of 57.5 months. Radiological workups and endoscopic procedures with a fat bath-plug were performed for all patients. Patient characteristics, initial presentation, locations and sizes of CSF leaks, surgical procedures, recurrences, complications at both donor and recipient graft sites were evaluated. Results: Of all patients, 7 suffered from traumatic CSF leaks and 9 congenital CSF leaks. Fourteen patients presented with CSF leaks and encephaloceles. The sites of skull base defects included cribriform plate (n=10), ethmoid roof (n=3), posterior wall of frontal sinus (n=2), and sphenoid roof (n=1). The maximum diameter of skull base defects included 1～4mm (n=4)，5～10mm (n=7)，and 11～20mm (n=5). Of all patients, 15 underwent endoscopic procedures successfully, while one patient required the neurosurgical service to repair a large posterior wall defect of frontal sinus from a car accident via open transcranial approaches. All patients had favorable clinical outcomes without any recurrences or complications during a follow-up of 24～60 months. Conclusions With easy procedure, less injuries and complications, the fat bath-plug technique is safe and effective for the endoscopic repair of both congenital and traumatic CSF leaks in children.
