A case of cerebrospinal fluid rhinorrhea following endoscopic ventricular lavage for ventriculitis after transsphenoidal surgery

Abstract

Cerebrospinal fluid (CSF) leakage is a rare but serious complication after transsphenoidal approach surgery (TSA), particularly in complex cases that also require endoscopic ventricular lavage to manage ventriculitis. We report a case of a 77-year-old female with recurrent clivus chordoma who developed ventriculitis and subsequent CSF leakage after multiple TSAs and endoscopic explorations. During endoscopic lavage, the surgical flap detached, leading to postoperative CSF leakage. Repair involved an innovative approach with autologous fat grafting and flap repositioning, successfully sealing the defect and resolving the infection. This case underscores the need for adaptive, multidisciplinary strategies to manage complex postoperative complications after skull base surgery.