Prevention of cerebrospinal fluid leak after translabyrinthine resection of vestibular schwannoma.
OBJECTIVE
Evaluate the rate of cerebrospinal fluid (CSF) leak after translabyrinthine craniotomy for the removal of vestibular schwannoma and describe details of closure technique.


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
All individuals undergoing translabyrinthine craniotomy for removal of vestibular schwannoma from January 2000 to October 2008.


METHODS
Translabyrinthine craniotomy for removal of vestibular schwannoma with abdominal fat graft harvest and layered closure.


METHODS
Presence of cerebrospinal fluid leak and need for additional surgeries or medical interventions.


RESULTS
Sixty-one patients underwent translabyrinthine craniotomy for the removal of vestibular schwannoma during a 9-year period. None of the patients had a CSF leak in the immediate postoperative period or during the mean follow-up period of 31.3 months.


CONCLUSIONS
Successful wound closure and CSF leak prevention after translabyrinthine craniotomy for the removal of vestibular schwannomas do not require the creation of a facial recess, manipulation of the ossicles, direct Eustachian tube plugging, or the use of alloplastic space-occupying materials. The closure technique used in the current study has proven effective over time with no evidence of CSF leak among patients seen in follow-up.
Goddard
John C
JC
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
Oliver
Eric R
ER
Lambert
Paul R
PR
D050153:Abdominal Fat / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000368:Aged; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology / Q000517:prevention & control*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000517:prevention & control*; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D013536:Suture Techniques; D014182:Transplantation, Autologous / Q000379:methods; D014722:Vestibule, Labyrinth / Q000601:surgery*