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Published on: February 29, 2020
Cerebrospinal fluid leak after retrosigmoid excision of vestibular schwannomas
Maurizio Falcioni1, Guglielmo Romano, Nitin Aggarwal
1Gruppo Otologico, Piacenza, Rome, Italy. maurizio.falcioni@gruppootologico.it
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.
Patients:
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.
Interventions:
The classic approach was adopted in the first 21 cases, whereas a retrolabyrinthine bone removal was added in the last 56.
Main Outcome Measure:
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.
Conclusion:
Extension of the classic RS that addressed retrolabyrinthine air cells is associated with a significant reduction in CSF leak manifesting rhinorrhea.
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