Prevention of cerebrospinal fluid leak after translabyrinthine resection of vestibular schwannoma.

OBJECTIVE

Evaluate the rate of cerebrospinal fluid (CSF) leak after translabyrinthine craniotomy for the removal of vestibular schwannoma and describe details of closure technique.

STUDY DESIGN

Retrospective case review.

SETTING

Tertiary referral center.

PATIENTS

All individuals undergoing translabyrinthine craniotomy for removal of vestibular schwannoma from January 2000 to October 2008.

INTERVENTION

Translabyrinthine craniotomy for removal of vestibular schwannoma with abdominal fat graft harvest and layered closure.

MAIN OUTCOME MEASURES

Presence of cerebrospinal fluid leak and need for additional surgeries or medical interventions.

RESULTS

Sixty-one patients underwent translabyrinthine craniotomy for the removal of vestibular schwannoma during a 9-year period. None of the patients had a CSF leak in the immediate postoperative period or during the mean follow-up period of 31.3 months.

CONCLUSION

Successful wound closure and CSF leak prevention after translabyrinthine craniotomy for the removal of vestibular schwannomas do not require the creation of a facial recess, manipulation of the ossicles, direct Eustachian tube plugging, or the use of alloplastic space-occupying materials. The closure technique used in the current study has proven effective over time with no evidence of CSF leak among patients seen in follow-up.