Prevention of CSF Leakage by Staged Operation for Clival Metastatic Tumor.
The transoral approach is a direct route to the clivus. However, application of this approach is infrequent because of the risk of cerebrospinal fluid (CSF) fistula and subsequent meningitis. We report a case of clival metastatic tumor treated by staged operation without CSF leakage. A 39-year-old man was found to have a tumor in clivus extending to the intradural space. Two-staged resection through the lateral suboccipital and transoral approach was performed and the dural defect was replaced by a fascia in the first operation. CSF leakage was prevented by this procedure. The patient received radiotherapy postoperatively.
Sako
K
K
Kimura
T
T
Sawamura
A
A
Yonemasu
Y
Y
Takahashi
M
M
Miyokawa
N
N