This middle aged lady presented with spontaneous watery nasal discharge. Clinical photograph demonstrates the C.S.F drip

     Endonasal view showing the C.S.F dripping along the middle turbinate. She was conservatively treated with acetazolamide for 2 weeks.when the leak persisted, surgical repair was undertaken.

MRI Scan showing the site of leak to be in the region of right cribriform plate.

HRCT with a contrast can also indicate the site of leak in a similair fashion

     Endoscopic repair of the CSF leak from the cribriform plate being carried out.The middle turbinate is resected to provide adequate working space A mucosal graft is tucked into the defect after freshening the edges.
       The bony defect seen after repair with mucosa taken from middle turbinate.The repaired defect is packing with Surgicel.The nasal cavity is then packed with Merocel and the pack kept insitu for 1 week.
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