Cerebrospinal fluid leakage after retrosigmoid craniotomy and craniectomy for cerebellopontine angle tumors: A...

The incidence of CSF leakage after surgery is very critical in the management of patients with cerebellopontine angle (CPA) tumors. The aim of our current study is to compare the outcome of retrosigmoid craniotomy and craniectomy in terms of the rate of postoperative CSF leakages and burdens such as in-hospital stay and cost on patients. In this comparative retrospective study, data was retrieved to identify the patients who underwent retrosigmoid craniotomy and craniectomy from January 2019 to December 2022 at Department of Neurosurgery, West China Hospital. Data such as age, sex, preoperative hydrocephalus, tumor type and sizes, length of in-hospital stay, cost, and intracranial infection were documented and compared. The primary outcome was development of postoperative CSF leakage. A total of 345 patients were retrieved, out of which 83 (24%) patients underwent craniotomy while 262 (76%) underwent craniectomy. The incidence of postoperative CSF leakage was significantly lower in the craniotomy group compared to the craniectomy group (P = .0059). Similarly, craniotomy was superior in terms of in-hospital stay (P < .0001) and average cost (P < .0001) compared to craniectomy. Craniotomy reduces incidence CSF leakage in cases where the dura could not be sutured in a watertight fashion compared to craniectomy. Also, craniectomy puts more burden on patients compared to craniotomy.