The Causes and Treatment for Cerebrospinal Fluid Leak after Microsurgical Removal of Vestibular Schwannomas
- VernacularTitle:听神经瘤术后脑脊液漏的原因及防治
- Author:
Daofeng TIAN
;
Hongguo WANG
;
Qianxue CHEN
- Publication Type:Journal Article
- Keywords:
Vestibular schwannomas;
Cerebrospinal fluid leak;
Suboccipital retrosigmoidal approach
- From:
Journal of Chinese Physician
2001;0(10):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the causes and treatment for cerebrospinal fluid(CSF) leak after microsurgical removal of vestibular schwannomas(VS) with the suboccipital retrosigmoid approach.Methods A retrospective study was accomplished on 258 patients with VS operated through the suboccipital retrosigmoidal approach from Jan 1994 to Aug 2003.After operation,cerebrospinal fluid rhinorrhea occurred in 19 cases and subcutaneous retroauricular CSF leak occurred in 5 cases.Results In 14 cases the CSF leak was stopped after treatment by external lumbar cerebrospinal fluid drainage(CELCFD).Six patients were operated again with sealing the internal acoustic meatus and the mastoid cells with fibrin glue and muscle.The patients were followed up for 14 months to 8 years after treatment,and there was no recurrence of CSF leak or delayed onset meningitis.Conclusion CSF leak was the common complication after vestibular schwannoma removal and the most common reason was the drilled posterior wall of the internal acoustic meatus with opening of the mastoid cells.The closure of petrous air cells was very important to prevent its postoperative CSF leak.Most of the patients were successfully treated by external lumbar cerebrospinal fluid drainage and only a few cases needed revision surgery.
