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Skull Base 1997; 7(3): 159-162
DOI: 10.1055/s-2008-1058608
Case Reports

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Prevention of CSF Leakage by Staged Operation for Clival Metastatic Tumor

Kazuhiro Sako, Teruo Kimura, Atushi Sawamura, Yukichi Yonemasu, Mitsuaki Takahashi, Naoyuki Miyokawa
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Publication Date:
03 March 2008 (online)

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Abstract

The transoral approach is a direct route to the clivus. However, application of this approach is infrequent because of the risk of cerebrospinal fluid (CSF) fistula and subsequent meningitis. We report a case of clival metastatic tumor treated by staged operation without CSF leakage. A 39-year-old man was found to have a tumor in clivus extending to the intradural space. Two-staged resection through the lateral suboccipital and transoral approach was performed and the dural defect was replaced by a fascia in the first operation. CSF leakage was prevented by this procedure. The patient received radiotherapy postoperatively.