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J Neurol Surg B Skull Base 2014; 75(06): 391-396
DOI: 10.1055/s-0034-1376196
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Subtotal Petrosectomy and Cerebrospinal Fluid Leakage in Unilateral Anacusis

Giuseppe Magliulo
1   Organi di Senso Department, University “La Sapienza,” Rome, Italy
,
Giannicola Iannella
1   Organi di Senso Department, University “La Sapienza,” Rome, Italy
,
Mario Ciniglio Appiani
1   Organi di Senso Department, University “La Sapienza,” Rome, Italy
,
Massimo Re
2   Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy
› Author Affiliations
Further Information

Publication History

31 October 2013

17 March 2014

Publication Date:
27 May 2014 (online)

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Abstract

Objective This study presents a group of patients experiencing recurrent cerebrospinal fluid (CSF) leakage associated with ipsilateral anacusis who underwent subtotal petrosectomies with the goal of stopping the CSF leak and preventing meningitis.

Materials and Methods Eight patients with CSF leakage were enrolled: three patients with giant vestibular schwannomas had CSF leakage after gamma knife failure and subsequent removal via a retrosigmoid approach; two patients had malformations at the level of the inner ear with consequent translabyrinthine fistulas; two had posttraumatic CSF leakages; and one had a CSF leakage coexisting with an encephalocele. Two patients developed meningitis that resolved with antibiotic therapy. Each patient had preoperative anacusis and vestibular nerve areflexia on the affected side.

Results The patients with congenital or posttraumatic CSF leaks had undergone at least one unsuccessful endaural approach to treat the fistula. All eight patients were treated successfully with a subtotal petrosectomy. The symptoms disappeared within 2 months postoperatively. No meningitis, signs of fistula, or other symptoms occurred during the follow-up.

Conclusion A subtotal petrosectomy should be the first choice of treatment in patients with recurrent CSF leakage whenever there is associated unilateral anacusis.

Keywords

CSF leakage - subtotal petrosectomy - unilateral anacusis
 

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