Cerebrospinal fluid fistula after transtemporal skull base surgery.
OBJECTIVE
The purpose of this article is to outline our methods for the prevention and management of cerebrospinal fluid (CSF) leak after transtemporal skull base surgery.


METHODS
A total of 589 patients underwent a variety of transtemporal surgical approaches for the extirpation of skull base tumors at our institution from July 1988 to October 1999. The medical records were retrospectively reviewed to identify the tumor histology, size, and location as well as the surgical approach, defect reconstruction technique, and the incidence of postoperative CSF leak.


RESULTS
The risk of CSF fistulae was greatest in utilizing the restrosigmoid approach (8%) and least in those who underwent a translabyrinthine approach (4%). Tumor size had no bearing on the incidence of the CSF leak and the overall incidence of meningitis was 1.0%.


CONCLUSIONS
The proper surgical technique will minimize the risk of CSF leak after transtemporal skull base surgery. Immediate management of CSF fistulae helped prevent meningitis in the majority of these patients.
Leonetti
J
J
Department of Otolaryngology-Head and Neck Surgery at the Loyola Center for Cranial Base Surgery, Maywood, Illinois 60153, USA. jleonet@lumc.com
Anderson
D
D
Marzo
S
S
Moynihan
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D010235:Paraganglioma / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control / Q000628:therapy*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*