Middle turbinate graft for repair of cerebral spinal fluid leaks

Endoscopic management of CSF leaks has been reported as highly successful by several authors. Various techniques are used for site preparation, graft selection, and graft stabilization. In this report the middle turbinate as a donor site for repair is described. Guidelines for harvest, preparation, and application are presented. The middle turbinate graft can be used as a free mucosal graft for linear cracks or small defects, as a composite bone/mucosal graft for moderate sized defects, or as a donor site for separate bone and mucosal grafts for large defects or encephaloceles when intracranial bone placement is desirable. Experience with 18 patients is presented with 100% initial graft take, and 17/18 (94%) with long term success. The middle turbinate is an excellent source of donor material for repair of almost any endoscopically repairable CSF leak.