[Treatment and prevention of cerebrospinal fluid leakage after craniofacial surgery for tumors involving the skull base].
OBJECTIVE
To evaluate the treatment and prevention of cerebrospinal fluid (CSF) leakage following removal of the skull base tumors with craniofacial approach.


METHODS
A retrospective review was undertaken to analyze the clinical data of 14 cases suffering from CSF leakage after craniofacial surgery for tumors involving the cranial base.


RESULTS
Ten (71.4%) case cured between 3 days and 32 days by conservative treatment including lumbar drainage. Three of four patients who needed operation had no CSF leakage after first attempt. One discontinuous leakage was closed after a second attempt. Among all cases,five(35.7%) patients developed meningitis,and one case died because of serious intracranial infection and respiration failure.


CONCLUSIONS
Continuous lumbar cerebrospinal fluid drainage is a safe and effective treatment of CSF leakage following craniofacial surgery. However,If conservative treatment fails to arrest CSF leakage,surgical therapy is recommend with multilayer reconstruction for dural defect so as to avoid meningitis. The vital procedure for prevention of CSF leakage is watertight seal of dura mater, reconstruction of bone defect and obliteration of dead space after craniofacial surgery.
Wang
Yong-qian
YQ
Department of Neurosurgery, Ninth People's Hospital, Shanghai Second Medical University, Shanghai 200011, China. studwyq@yahoo.com.cn
Ding
Mei-xiu
MX
Guo
Zhi-lin
ZL
Wang
Bin-yu
BY
Wu
Yi-qun
YQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002559:Cerebrospinal Fluid Rhinorrhea / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*