A technique to reduce CSF leakage after acoustic neuroma surgery

Leakage of CSF remains a frequent complication of acoustic neuroma surgery in contrast with the significant reductions achieved in mortality and morbidity. The rate of CSF leakage following acoustic neuroma excision is presented for 49 consecutive patients. The first 23 operations were performed before the introduction of a new technique for sealing off air cells in the internal auditory meatus and the following 26 with this new method. CSF leakage occurred in nine of the first 23 patients compared with one of 26 patients using this method (p < 0.01). The two groups were similar for tumour size and facial nerve preservation rate. The technique, which avoids the need for a second donor site wound or continuous lumbar drainage, is described and factors leading to CSF leakage are discussed.