[Prevention and therapy of cerebrospinal fluid leakage after translabyrinthine acoustic neuroma removal].

OBJECTIVE

To evaluate the modified wound closure technique and other methods for preventing and treating the cerebrospinal fluid (CSF) leakage after removal of acoustic neuroma by translabyrinthine approach.

METHODS

In a series of 85 cases of acoustic neuroma surgery, two kinds of technique of wound closure, the traditional (as first group) and the modified (as second group), have been subsequently used to prevent CSF leakage. The incidences of CSF leak were analyzed respectively. Conservative and surgical treatments were applied to treatment the CSF leak.

RESULTS

In the first group, the CSF leak was 19.5% (8/41), and that of second group was 2.3% (1/44). There was significant difference between them (P = 0.013). The CSF leak mainly occurred in large acoustic neuromas surgery with traditional wound closure technique. Among 9 cases of CSF leaks, 3 were controlled by conservative method, 5 by one single revision surgery and one by two revisions.

CONCLUSIONS

The revision technique of wound closure could significantly reduce the incidence of CSF leakage after acoustic neuroma removal by translabyrinthine approach. The revision surgery is an effective method for stopping the CSF leak.