title: Incidence of cerebrospinal fluid leak following petrosectomy and analysis of avoidance techniques.
abstract: A cerebrospinal fluid (CSF) leak following skull base surgery can lead to meningitis, impaired wound healing, and often requires re-operation and/or CSF diversion. Thirty-two patients underwent a presigmoid, transpetrosal approach to skull base aneurysms and tumors. A vascularized temporalis muscle flap was utilized during the closure of the initial skull base reconstruction in 18 of the 32 patients. A temporary CSF diversion was utilized in 23 of the 32 patients. A permanent shunt was placed in eight patients. One patient developed a postoperative CSF leak from the contralateral ear due to a congenital abnormality in the middle ear. Another patient, who did not have a vascularized temporalis muscle flap reconstruction, developed a postoperative CSF leak in the context of an operation for recurrent tumor and prior radiation treatment. CSF diversion and vascularized temporalis muscle flaps are effective in preventing the development of postoperative CSF leaks following petrosectomy.
authors: Department of Neurosurgery, Massachusetts General Hospital & Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors: Brian P
authors: BP
authors: Walcott
authors: Brian V
authors: BV
authors: Nahed
authors: Yaw
authors: Y
authors: Sarpong
authors: Kristopher T
authors: KT
authors: Kahle
authors: Laligam N
authors: LN
authors: Sekhar
authors: Manuel J
authors: MJ
authors: Ferreira
mesh_terms: D000328:Adult; D000368:Aged; D065634:Cerebrospinal Fluid Leak; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology* / Q000517:prevention & control*; D015331:Cohort Studies; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010579:Petrous Bone / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology / Q000601:surgery*; D055815:Young Adult