Transnasal endoscopic repair of cerebrospinal fluid fistula is recommended for patients with post-traumatic cerebrospinal fluid leaks who do not respond to conservative treatment. It is a safer and more successful alternative to transcranial surgery.

We present our experience of using septal cartilage and temporalis fascia in this transnasal endoscopic approach for the repair of the large defect of anterior skull base cerebrospinal fistula and meningoencephalocele. Use of microdebrider is highlighted in the technique for the debridement of the encephalocele and complete exposure of the defect.