A systematic review of contemporary strategies for managing high-flow cerebrospinal fluid leaks, with particular relevance to endoscopic skull-base reconstruction.

Alsudays, Almanea, Almutairi and colleagues reviewed the available literature on high-flow CSF leak repair, including endoscopic skull-base reconstruction strategies and their reported outcomes.

The review found a high overall success rate for endoscopic repair, while highlighting persistent variation in reconstructive technique, the role of multilayer closure, dural suturing, rigid support materials and adjunctive CSF diversion.

Why it matters

High-flow CSF leak remains one of the key technical determinants of success in expanded endoscopic endonasal surgery. This review is useful because it synthesizes the current reconstructive options and places newer techniques—such as direct dural or diaphragmatic suturing—within the broader evidence base.

Reference

Alsudays AM, Almanea KA, Almutairi HM, et al.
Management Strategies for High-Flow Cerebrospinal Fluid Leaks: A Systematic Review.
Journal of Craniofacial Surgery. Published September 28, 2026.
DOI: 10.1097/SCS.0000000000013348
View on PubMed