Technique to avoid cerebrospinal fluid otorhinorrhea with translabyrinthine removal of acoustic neuroma

A technique to avoid cerebrospinal fluid otorhinorrhea with translabyrinthine removal of acoustic neuroma is described. Its successful use in 100 consecutive cases with only one incident of cerebrospinal fluid otorhinorrhea suggests that it is an effective technique which has minimal morbidity. Intraoperative and postoperative intravenous antibiotics and the use of bacitracin irrigation during surgery are desirable additions to the technique. The procedure is accomplished in 10 minutes and involves scarifying the tubotympanum and obliteration with fibrous tissue through the facial recess approach. Coupled with obliteration of the petrous apex and mastoid with fat, postoperative CSF otorhinorrhea following translabyrinthine acoustic neuroma removal can be almost complete eliminated.