CSF Rhinorrhoea after Endonasal Intervention to the Anterior Skull Base – An international prospective service evaluation on Incidence and Management

Dear NANSIG members,

We have another exciting opportunity for you as medical students and junior doctors to get involved in. We are now launching our latest international study, titled:

CRANIAL – Cerebrospinal Fluid (CSF) Rhinorrhoea After Endonasal Intervention to the Anterior Skull Base.

What is the study about?

We are interested in understanding the contemporary practice of two minimally invasive surgical approaches: the endonasal transsphenoidal approach (TSA) and the expanded endonasal approach (EEA). These approaches are used to target pathologies of the skull base, such as pituitary tumours, meningiomas, craniopharyngiomas, etc.

Currently, there is no consensus on the ways in which we reconstruct the skull base during these surgeries. The method used to repair the skull base is important for determining whether a patient develops cerebrospinal fluid (CSF) leakage. Therefore, the incidence of CSF leak is also very variable after these surgeries.

To this end, the aim of this study is to evaluate: (1) the methods of skull base repair, and (2) the corresponding rates of post-operative CSF rhinorrhoea after TSA and EEA surgery. We hope to do this via a multicentre, prospective service evaluation.

We have a steering committee of skull base consultants in the UK and Ireland who will be consultant leads at their respective centres and work closely with local student and junior doctor/trainee leads. We are looking for medical student and junior doctor (in training or staff grade) at these recruited centres (see google form) to collaborate with us on this NANSIG-led (and BNTRC supported) study. Please see the attached poster.


What does this project involve? (see attached PowerPoint for more info)

  • Registering the project as a service evaluation with your local audit department.
  • Forming a team with the appointed consultant lead, trainee lead and student lead.
  • Collecting data (pre-op, intra-op and post-op) as a team using a user-friendly electronic survey (Castor EDC).
  • Data collection will include 6 months of case recruitment and up to 6 months of case follow-up. 

How do I get involved?:

  1. The first step is to apply to be a local CRANIAL study lead (student or trainee) via this google form Please indicate if you are based at one of the eligible centres (those in which we already have consultant approval in).
  2. Soon after this, we will inform successful candidates of their local team members and schedule a welcome call. We will provide guides and supporting materials for all steps (project registration, data collection, day-to-day support) to make the process as efficient and enjoyable as possible.

Application form:

Deadline is 23:59 18th January 2020.


We look forward to working with you!