ObjectiveTo assess the safety and validity of 'bath-plug'technique for endoscopic repair of cerebrospinal fluid leaks in children.MethodsClinical data of 16 patients undergoing endoscopic repair of cerebrospinal fluid leaks utilizing abdominal free fat from Sept 2016 to Sept 2019 were analyzed retrospectively. There were 10 boys and 6 girls, aged from 5 to 123 months with a median age of 57.5 months. Radiological workups and endoscopic procedures with a fat bath-plug were performed for all patients. Patient characteristics, initial presentation, locations and sizes of cerebrospinal fluid leaks, surgical procedures, recurrences, complications at both donor and recipient graft sites were evaluated.ResultsOf all the patients, 7 suffered from traumatic cerebrospinal fluid leaks and 9 congenital cerebrospinal fluid leaks. Fourteen patients presented with cerebrospinal fluid leaks and encephaloceles. The sites of skull base defects included cribriform plate (n=10), ethmoid roof (n=3), posterior wall of frontal sinus (n=2), and sphenoid roof (n=1). The maximum diameter of skull base defects was 1~4mm in 4 cases, 5~10mm in 7, and 11~20mm in 5. Of all the patients, 15 underwent endoscopic procedures successfully, while one patient required the neurosurgical service to repair a large posterior wall defect of frontal sinus via open transcranial approach. All patients had favorable clinical outcomes without any recurrences or complications during a follow-up of 24~60 months.ConclusionWith easy procedure, less injuries and complications, the fat bath-plug technique is safe and effective for the endoscopic repair of both congenital and traumatic cerebrospinal fluid leaks in children.