Endoscopic Repair of Cerebrospinal Fluid Leaks in a Resource‐Limited Setting in Ghana

Objective This study assesses the outcomes of patients who underwent repair of skull base defects and cerebrospinal fluid (CSF) leaks via endoscopic endonasal approach (EEA) in a resource‐limited tertiary care center in Ghana. Study Design A retrospective cohort study. Setting Korle Bu Teaching Hospital in Accra, Ghana, a tertiary public institution with recent international collaboration. Methods This retrospective cohort study analyzes patients presenting to Korle Bu Teaching Hospital with skull base defects and CSF leaks over a 5‐year period treated with single‐stage EEA repair. A comprehensive review was conducted to analyze demographics, characteristics of skull base defect, surgical approach, and outcomes. Results Eight patients were included for analysis. All patients underwent multilayer closure using combinations of autologous grafts, including abdominal fat, middle turbinate grafts, and vascularized nasoseptal flaps. Intraoperative lumbar drains and intraoperative fluorescein were not used. There were no postoperative CSF leaks over a follow‐up period ranging from 6 months to over 4 years. Conclusion EEA can be adapted safely and effectively in low‐resource settings. Keys to successful implementation include meticulous surgical technique, utilization of locally available or autologous graft materials, and rigorous postoperative protocols.