title: [Causal analysis and management strategies of cerebrospinal fluid leakage following translabyrinthine approach for acoustic neuromas].
abstract: OBJECTIVE
  The purpose of the report was to investigate the causes of CSF leakage and discuss the methods for prevention and management of CSF leakage following translabyrinthine resection of acoustic neuromas.
  
  
  METHODS
  A retrospective review of cerebrospinal fluid leakage following translabyrinthine approach for 152 acoustic neuromas patients, from January 1983 to December 2013, was performed. The cases were divided into two groups, traditional and modified closure techniques. The incidence of CSF leakage was compared between the two groups.
  
  
  RESULTS
  The incidence of postoperative CSF leakage by translabyrinthine approach was 5.9% (9/152), with four cases of rhinorrhea, two case of wound leakage, one case of rhinorrhea and otorrhea, one case of otorrhea, and one case of rhinorrhea and wound leakage. The CSF leakage incidence of traditional closure technique was 14.3% (5/35); the incidence of modified closure technique was 3.4% (4/117). After introducing a modified closure technique, the incidence of the CSF leakage significantly decreased.
  
  
  CONCLUSIONS
  As a common complication of translabyrinthine approach, the incidence of CSF leakage is closely related to the closure technique. The incidence of the CSF leakage should decrease dramatically when adopting the modified closure technique.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Institute of Otorhinolaryngology, General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Xiuju
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Institute of Otorhinolaryngology, General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Shen
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Institute of Otorhinolaryngology, General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Pu
authors.initials: P
authors.lastname: Dai
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Institute of Otorhinolaryngology, General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Weiyang
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Institute of Otorhinolaryngology, General Hospital of People's Liberation Army, Beijing 100853, China.
authors.forename: Dongyi
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Institute of Otorhinolaryngology, General Hospital of People's Liberation Army, Beijing 100853, China. Email: yangsm301@263.net.
authors.forename: Shiming
authors.initials: S
authors.lastname: Yang
mesh_terms: D000328:Adult; D065634:Cerebrospinal Fluid Leak / Q000517:prevention & control*; D003399:Craniotomy; D007758:Ear, Inner / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies