Cerebrospinal fluid leak after retrosigmoid excision of vestibular schwannomas.
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.


METHODS
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.


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


METHODS
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.


CONCLUSIONS
Extension of the classic RS that addressed retrolabyrinthine air cells is associated with a significant reduction in CSF leak manifesting rhinorrhea.
Falcioni
Maurizio
M
Gruppo Otologico, Piacenza, Rome, Italy. maurizio.falcioni@gruppootologico.it
Romano
Guglielmo
G
Aggarwal
Nitin
N
Sanna
Mario
M
D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed