During the early follow-up period, failure of endoscopic frontal sinusotomy is associated with advanced degrees of preoperative disease within the sinus and is also more likely in patients who have failed prior surgical management.

traditionally been treated by both otolaryngologists and neurosurgeons. Over the past few decades, the extracranial approach has become increasingly popular, with the intracranial approach being kept as a reserve. The advances in endoscopic sinus surgery have made it the procedure of choice for treatment of CSFR. To analyze the feasibility and efficacy of endoscopic closure of CSFR in various settings was the objective of the present study.Methods: We conducted a retrospective study of 267 cases of CSFR treated by the transnasal endoscopic approach over a period of 10 years from 1992 to 2002. Diagnosis was achieved with the help of CT cisternography, MRI, beta-2 transferrin levels of the rhinorrhea, or any combination of the above. All patients were operated upon endoscopically. Fascia lata and fat were used to plug the defects. The patients were followed up for a period of 6 months from the day of surgery.Results: The CSFR was successfully plugged in 258 patients. 9 patients required revision surgeries, out of which 6 could be plugged successfully endoscopically. In 2 of the remaining 3 patients a neurosurgical approach was used for the closure, and 1 patient was lost to follow-up.Conclusions: In our experience with 267 patients with endoscopically treated CSFR, the results of achieving the closure was 96.63% in the first instance. On including the revision surgeries, this was close to 98.88%, proving that even in a setting of revision surgery, it is possible to use this method and achieve good results. TUESDAYOtolaryngology-Head and Neck Surgery Volume 129 Number 2 Scientific Session-Tuesday P145