Download PDF
J Neurol Surg B Skull Base 2012; 73(05): 327-330
DOI: 10.1055/s-0032-1321511
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dural Defect Repair in Translabyrinthine Acoustic Neuroma Surgery and Its Implications in Cerebrospinal Fluid Leak Occurrence

Aloysio Augusto Tahan de Campos Netto
1   Department of Otolaryngology-Head and Neck Surgery, Scholl of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil
,
José Fernando Colafêmina
1   Department of Otolaryngology-Head and Neck Surgery, Scholl of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil
,
Ricardo Silva Centeno
2   Department of Neurosurgery, Federal University of São Paulo, São Paulo-SP, Brazil
› Author Affiliations
Further Information

Publication History

11 January 2012

16 March 2012

Publication Date:
30 July 2012 (online)

Also available at
    Permissions and Reprints

Abstract

Cerebrospinal fluid (CSF) leak is a complication that may occur after translabyrinthine (translab) acoustic neuroma (AN) removal. The aim of this study is to verify the incidence of CSF leak using two techniques for dural defect closure in translab AN surgery and present a new technique for dural repair. A retrospective study was held, reviewing charts of 34 patients in a tertiary neurotologic referral center. Out of these 34 patients that underwent translab AN excision in a 1-year period, 18 had their dural defect repaired using only abdominal fat graft and 16 using synthetic dura substitute (SDS) plus abdominal fat tissue. One patient (5.5%) in the first group had CSF leak and 1 (6.2%) in the second group had CSF leak postoperatively. Our data suggest that there are no significant differences in CSF leak rates using both techniques, although studies in a larger series must be undertaken to conclude it. We believe that the development of some points in the new technique for dural repair can achieve better results and reduce the CSF leak incidence in the translabyrinthine acoustic neuroma surgery in the near future.

Keywords

acoustic neuroma - translabyrinthine - cerebrospinal fluid leak - dural defect
 

  • References

  • 1 Hardy DG, Macfarlane R, Moffat DA. Wound closure after acoustic neuroma surgery. Br J Neurosurg 1993; 7: 171-174
    CrossrefPubMedGoogle Scholar
  • 2 Walcott BP, Nahed BV, Sarpong Y, Kahle KT, Sekhar LN, Ferreira MJ. Incidence of cerebrospinal fluid leak following petrosectomy and analysis of avoidance techniques. J Clin Neurosci 2012; 19: 92-94
    CrossrefPubMedGoogle Scholar
  • 3 Bejjani GK, Zabramski J. Safety and efficacy of the porcine small intestinal submucosa dural substitute: results of a prospective multicenter study and literature review. J Neurosurg 2007; 106: 1028-1033
    CrossrefPubMedGoogle Scholar
  • 4 Becker SS, Jackler RK, Pitts LH. Cerebrospinal fluid leak after acoustic neuroma surgery: a comparison of the translabyrinthine, middle fossa, and retrosigmoid approaches. Otol Neurotol 2003; 24: 107-112
    CrossrefPubMedGoogle Scholar
  • 5 Selesnick SH, Liu JC, Jen A, Newman J. The incidence of cerebrospinal fluid leak after vestibular schwannoma surgery. Otol Neurotol 2004; 25: 387-393
    CrossrefPubMedGoogle Scholar
  • 6 Goddard JC, Oliver ER, Lambert PR. Prevention of cerebrospinal fluid leak after translabyrinthine resection of vestibular schwannoma. Otol Neurotol 2010; 31: 473-477
    CrossrefPubMedGoogle Scholar
  • 7 Wu H, Kalamarides M, Garem HE, Rey A, Sterkers O. Comparison of different wound closure techniques in translabyrinthine acoustic neuroma surgery. Skull Base Surg 1999; 9: 239-242
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Falcioni M, Mulder JJ, Taibah A, De Donato G, Sanna M. No cerebrospinal fluid leaks in translabyrinthine vestibular schwannoma removal: reappraisal of 200 consecutive patients. Am J Otol 1999; 20: 660-666
    PubMedGoogle Scholar
  • 9 Mangus BD, Rivas A, Yoo MJ , et al. Management of cerebrospinal fluid leaks after vestibular schwannoma surgery. Otol Neurotol 2011; 32: 1525-1529
    CrossrefPubMedGoogle Scholar