DOI: https://doi.org/10.36347/sasjs.2026.v12i06.005

Pages: 552-560

An osteomeningeal defect (OMD) is a discontinuity in the osteomeningeal barrier that allows cerebrospinal fluid (CSF) to leak into an air-filled cavity at the skull base. Our study is a retrospective analysis of 11 cases of osteomeningeal breaches treated using the endonasal endoscopic approach between January 2016 and January 2025. The study involved epidemiological, clinical, radiological, therapeutic, and evolutionary analyses. Our series was characterized by female predominance. The age of our patients varied between 3 and 58 years, with an average age of 36.7. The most frequently revealed symptom is cerebrospinal fluid rhinorrhea. CT scan and MRI were performed on all patients. The location of the defect was ethmoidal in eight cases, sphenoidal in three cases, associated with a meningoencephalocele in four cases, and a meningocele in two cases. All cases were operated on using an endonasal endoscopic approach performed by a dual team of ENT and neurosurgery specialists. A combination of different materials was used for reconstruction, including abdominal fat, fascia lata aponeurosis, septal cartilage, nasoseptal flap, and biological glue. Early endoscopic management of cerebrospinal fluid rhinorrhea is the first-line therapeutic option as it reduces morbidity and mortality, preserves olfactory function, and does not preclude classical neurosurgical closure in case of failure.