title: Prevention of Postoperative Cerebrospinal Fluid Leaks After Translabyrinthine Tumor Resection With Resorbable Mesh Cranioplasty.
abstract: OBJECTIVE
  To evaluate the effectiveness of resorbable mesh cranioplasty at reducing postoperative cerebrospinal fluid (CSF) leak and pseudomeningocele formation after translabyrinthine tumor resection.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary academic referral center.
  
  
  METHODS
  Fifty-three consecutive cases using a resorbable mesh cranioplasty after translabyrinthine tumor resection were reviewed.
  
  
  METHODS
  Temporal bone defects were repaired with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws.
  
  
  METHODS
  Primary outcome measures included the incidence of postoperative CSF wound leak or rhinorrhea, pseudomeningocele formation, and surgical site infection.
  
  
  RESULTS
  Fifty-three cases (average age, 54.0 yr; range, 19.3-75.1 yr) were analyzed. The average body mass index was 30.8 kg/m2 (range, 17.9-48.3 kg/m2), and the average tumor size was 18.8 mm (range, 8-38 mm). One patient (1.9%) experienced CSF rhinorrhea on postoperative Day 16, which resolved after transmastoid middle ear and eustachian tube packing. One patient (1.9%) experienced a surgical site infection requiring surgical debridement and mesh removal 4 months after surgery. Compared with 1,441 prior translabyrinthine surgeries analyzed from our institution using a traditional fat graft closure without mesh, the rate of postoperative CSF leak was significantly less using the resorbable mesh cranioplasty technique (p = 0.0483).
  
  
  CONCLUSIONS
  Resorbable mesh cranioplasty is a safe and effective method to reduce postoperative CSF leak and pseudomeningocele formation after translabyrinthine craniotomy for tumor excision.
authors.affiliation: *The Otology Group of Vanderbilt University, Department of Otolaryngology-Head and Neck Surgery †Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Hunter
authors.forename: Alex D
authors.initials: AD
authors.lastname: Sweeney
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Carlson
authors.forename: George B
authors.initials: GB
authors.lastname: Wanna
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rivas
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Weaver
authors.forename: Lola B
authors.initials: LB
authors.lastname: Chambless
authors.forename: Reid S
authors.initials: RS
authors.lastname: Thompson
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
authors.forename: Marc L
authors.initials: ML
authors.lastname: Bennett
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D002558:Cerebrospinal Fluid Otorrhea / Q000517:prevention & control*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000517:prevention & control*; D003399:Craniotomy / Q000379:methods*; D005064:Eustachian Tube / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008588:Meningocele; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013526:Surgical Mesh; D013701:Temporal Bone / Q000601:surgery*; D055815:Young Adult