Abstract
In a series of 277 patients with translabyrinthine acoustic neuroma, three techniques of wound closure were used to prevent cerebrospinal fluid (CSF) leakage. In the first group, we used a piece of fascia to cover the dural defect and then placed several pieces of fat on the fascia. The incidence of CSF leak was 28.2%; 7.7% required reoperation. In the second group, in addition to the fasia-fat complex, we made a large musculoperiosteal flap to compress the fat. The incidence of CSF leak and revision were not reduced, however. In recent cases, we placed several pieces of fat directly into the operative cavity without fascia graft; then it was covered with a musculoperiosteal flap. With this technique, CSF leak was significantly reduced to 7.4%, and reoperation was rare (3.7%). The direct application of fat into the translabyrinthine operation cavity appears to be effective to prevent CSF leaks.
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Selected References
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- Bryce G. E., Nedzelski J. M., Rowed D. W., Rappaport J. M. Cerebrospinal fluid leaks and meningitis in acoustic neuroma surgery. Otolaryngol Head Neck Surg. 1991 Jan;104(1):81–87. doi: 10.1177/019459989110400115. [DOI] [PubMed] [Google Scholar]
- Celikkanat S. M., Saleh E., Khashaba A., Taibah A., Russo A., Mazzoni A., Sanna M. Cerebrospinal fluid leak after translabyrinthine acoustic neuroma surgery. Otolaryngol Head Neck Surg. 1995 Jun;112(6):654–658. doi: 10.1016/S0194-59989570171-0. [DOI] [PubMed] [Google Scholar]
- Glasscock M. E., 3rd, Kveton J. F., Jackson C. G., Levine S. C., McKennan K. X. A systematic approach to the surgical management of acoustic neuroma. Laryngoscope. 1986 Oct;96(10):1088–1094. doi: 10.1288/00005537-198610000-00008. [DOI] [PubMed] [Google Scholar]
- Hardy D. G., Macfarlane R., Baguley D., Moffat D. A. Surgery for acoustic neurinoma. An analysis of 100 translabyrinthine operations. J Neurosurg. 1989 Dec;71(6):799–804. doi: 10.3171/jns.1989.71.6.0799. [DOI] [PubMed] [Google Scholar]
- Hoffman R. A. Cerebrospinal fluid leak following acoustic neuroma removal. Laryngoscope. 1994 Jan;104(1 Pt 1):40–58. doi: 10.1288/00005537-199401000-00009. [DOI] [PubMed] [Google Scholar]
- House J. L., Hitselberger W. E., House W. F. Wound closure and cerebrospinal fluid leak after translabyrinthine surgery. Am J Otol. 1982 Oct;4(2):126–128. [PubMed] [Google Scholar]
- Mangham C. A. Complications of translabyrinthine vs. suboccipital approach for acoustic tumor surgery. Otolaryngol Head Neck Surg. 1988 Oct;99(4):396–400. doi: 10.1177/019459988809900408. [DOI] [PubMed] [Google Scholar]
- Rodgers G. K., Luxford W. M. Factors affecting the development of cerebrospinal fluid leak and meningitis after translabyrinthine acoustic tumor surgery. Laryngoscope. 1993 Sep;103(9):959–962. doi: 10.1288/00005537-199309000-00003. [DOI] [PubMed] [Google Scholar]
- Shea M. C., Robertson J. T. Acoustic neuroma removal: a comparative study of translabyrinthine and suboccipital approaches. Am J Otol. 1979 Oct;1(2):94–99. [PubMed] [Google Scholar]
- Tos M., Thomsen J. Cerebrospinal fluid leak after translabyrinthine surgery for acoustic neuroma. Laryngoscope. 1985 Mar;95(3):351–354. doi: 10.1288/00005537-198503000-00026. [DOI] [PubMed] [Google Scholar]