title: Cerebrospinal fluid leak after retrosigmoid excision of vestibular schwannomas.
abstract: 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.
authors: Gruppo Otologico, Piacenza, Rome, Italy. maurizio.falcioni@gruppootologico.it
authors: Maurizio
authors: M
authors: Falcioni
authors: Guglielmo
authors: G
authors: Romano
authors: Nitin
authors: N
authors: Aggarwal
authors: Mario
authors: M
authors: Sanna
mesh_terms: 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