Cerebrospinal fluid leak after retrosigmoid excision of vestibular schwannomas.

Abstract

OBJECTIVE:

To investigate the effectiveness of a modification of the retrosigmoid (RS) approach in reducing the rate of postoperative cerebrospinal fluid (CSF) leak after vestibular schwannoma surgery.

PATIENTS:

Of 1,499 vestibular schwannomas operated on at the Gruppo Otologico between April 1987 and July 2006, 84 cases have been selected, all of them treated through the RS approach.

INTERVENTIONS:

The classic approach was adopted in the first 21 cases, whereas a retrolabyrinthine bone removal was added in the last 56.

MAIN OUTCOME MEASURE:

Percentage of postoperative CSF leak.

RESULTS:

The overall percentage of postoperative CSF leak was 8.3%. However, the percentage decreased from 21.4 to 1.8% after the surgical modification, with a single leak recorded in the second group. The only drawback was an additional surgical time of 40 minutes.

CONCLUSION:

Extension of the classic RS that addressed retrolabyrinthine air cells is associated with a significant reduction in CSF leak manifesting rhinorrhea.

• Authors: Maurizio Falcioni, Guglielmo Romano, Nitin Aggarwal, Mario Sanna
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 29 Issue 3 Pg. 384-6 (Apr 2008) ISSN: 1531-7129 [Print] United States
• PMID: 18364575 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Cerebrospinal Fluid Rhinorrhea (etiology)
• Female
• Humans
• Male
• Medical Records
• Middle Aged
• Neuroma, Acoustic (surgery)
• Neurosurgical Procedures (methods)
• Postoperative Complications (diagnostic imaging, prevention & control)
• Tomography, X-Ray Computed