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Primary Dural Closure for Retrosigmoid Approaches.

Garrett T Venable1, Mallory L Roberts1, Ryan P Lee1

  • 1College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States.

Journal of Neurological Surgery. Part B, Skull Base
|July 17, 2018
PubMed
Summary
This summary is machine-generated.

Primary closure of the posterior fossa dura using a simple technique can prevent cerebrospinal fluid (CSF) leaks after retrosigmoid approaches. This method avoids grafts and lumbar drains, reducing complication rates.

Keywords:
CSF leakprimary dural closureretrosigmoid approachretrosigmoid craniotomy

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Area of Science:

  • Neurosurgery
  • Surgical Techniques
  • Cerebrospinal Fluid Dynamics

Background:

  • Posterior fossa dura closure after retrosigmoid approaches presents challenges.
  • Postoperative cerebrospinal fluid (CSF) leaks are a common complication.

Purpose of the Study:

  • To describe a simple technique for primary dural closure following retrosigmoid approaches.
  • To report the incidence of CSF leaks using this technique.

Main Methods:

  • Retrospective chart review of 86 retrosigmoid craniotomies (February 2009-February 2015).
  • Primary outcome: postoperative CSF leak or pseudomeningocele.
  • Secondary outcomes: length of stay, lesion type, and other complications.

Main Results:

  • No allo- or autografts were required for dural repair.
  • No lumbar drains were used.
  • Zero patients experienced CSF otorrhea, rhinorrhea, or incisional leaks.

Conclusions:

  • Primary dural closure is feasible in retrosigmoid approaches without grafts.
  • This technique, combined with posterior fossa closure methods, may prevent CSF leaks.
  • Meticulous handling of the dural flap is crucial for successful closure.