Management strategies for anterior cranial skull base defects with or without associated cerebrospinal fluid (CSF) leak are well described in modern otolaryngologic and neurosurgical literature [1, 2]. These defects can be spontaneous or related to trauma (iatrogenic vs accidental), neoplasm, or congenital etiologies. Historically, defects of the anterior skull base were managed using external approaches requiring skin incisions with craniotomies. Over the past three decades, advancements and widespread experience in transnasal endoscopic strategies for approach and repair of skull base defects have shifted treatment paradigms in skull base surgery [3]. Today, endoscopic techniques are considered the standard of care for many anterior skull base pathologies, including anterior cranial skull base defects with or without an associated CSF leak.