Prevention of cerebrospinal fluid leak after translabyrinthine resection of vestibular schwannoma.

Abstract

OBJECTIVE:

Evaluate the rate of cerebrospinal fluid (CSF) leak after translabyrinthine craniotomy for the removal of vestibular schwannoma and describe details of closure technique.

STUDY DESIGN:

Retrospective case review.

SETTING:

Tertiary referral center.

PATIENTS:

All individuals undergoing translabyrinthine craniotomy for removal of vestibular schwannoma from January 2000 to October 2008.

INTERVENTION:

Translabyrinthine craniotomy for removal of vestibular schwannoma with abdominal fat graft harvest and layered closure.

MAIN OUTCOME MEASURES:

Presence of cerebrospinal fluid leak and need for additional surgeries or medical interventions.

RESULTS:

Sixty-one patients underwent translabyrinthine craniotomy for the removal of vestibular schwannoma during a 9-year period. None of the patients had a CSF leak in the immediate postoperative period or during the mean follow-up period of 31.3 months.

CONCLUSION:

Successful wound closure and CSF leak prevention after translabyrinthine craniotomy for the removal of vestibular schwannomas do not require the creation of a facial recess, manipulation of the ossicles, direct Eustachian tube plugging, or the use of alloplastic space-occupying materials. The closure technique used in the current study has proven effective over time with no evidence of CSF leak among patients seen in follow-up.

• Authors: John C Goddard, Eric R Oliver, Paul R Lambert
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 31 Issue 3 Pg. 473-7 (Apr 2010) ISSN: 1537-4505 [Electronic] United States
• PMID: 20084041 (Publication Type: Journal Article)

Topics

• Abdominal Fat (transplantation)
• Adolescent
• Adult
• Aged
• Cerebrospinal Fluid Otorrhea (etiology, prevention & control)
• Cerebrospinal Fluid Rhinorrhea (etiology, prevention & control)
• Craniotomy (adverse effects, methods)
• Female
• Humans
• Male
• Middle Aged
• Neuroma, Acoustic (surgery)
• Otologic Surgical Procedures (adverse effects, methods)
• Retrospective Studies
• Suture Techniques
• Transplantation, Autologous (methods)
• Vestibule, Labyrinth (surgery)