J Neurol Surg B Skull Base 2014; 75(05): 354-357
DOI: 10.1055/s-0034-1373659
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Impact of Chemoradiotherapy on CSF Leak Repair after Skull Base Surgery

Marcus V. Ortega Alves
1   Department of Medicine, Tufts University, Somerville, Massachusetts, United States
,
Dianna Roberts
2   Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
,
Nicholas B. Levine
3   Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Faculty Center, Houston, Texas, United States
,
Franco DeMonte
3   Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Faculty Center, Houston, Texas, United States
,
Ehab Y. Hanna
2   Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
,
Michael E. Kupferman
2   Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

23. Januar 2014

19. Februar 2014

Publikationsdatum:
04. Juni 2014 (online)

Abstract

Background Transnasal endoscopic resection (TER) has become the treatment of choice for many skull base tumors. A major limitation of TER is the management of large dural defects and the need for repair of cerebrospinal fluid (CSF) leaks, particularly among patients who are treated with chemotherapy (CTX) or radiotherapy (RT). The objective of this study is to determine the impact of CTX and RT on the success of CSF leak repair after TER.

Methods We performed a retrospective chart review of a single-institution experience of TER from 1992 to 2011.

Results We identified 28 patients who had endoscopic CSF leak repair after resection of malignant skull base tumors. Preoperative RT was utilized in 18 patients, and 9 had undergone CTX. All patients required CSF leak repair with rotational flaps after cribriform and/or dural resection. CSF leak repair failed in three patients (11%). A history of RT or CTX was not associated with failed CSF leak repair.

Conclusion Adjuvant or neoadjuvant CTX or RT is not associated with failed CSF leak repair. Successful CSF leak repair can be performed in patients with malignant skull base tumors with an acceptable risk profile.

Notes

Presented at the XXII North American Skull Base Surgery Meeting, Las Vegas, Nevada, February 2012.


 
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