Resorbable plate cranioplasty after the translabyrinthine approach.

OBJECTIVE

To determine the safety of resorbable plate cranioplasty after translabyrinthine cerebellopontine angle tumor excision and to determine efficacy of this technique in the reduction of cerebrospinal fluid (CSF) leaks compared with fat grafting alone.

STUDY DESIGN

Prospective clinical trial with matched, historic case controls.

SETTING

University tertiary referral center.

PATIENTS

Seventy-one patients with tumors of the cerebellopontine angle undergoing a translabyrinthine approach had the temporal bone defect repaired by a fat graft secured with a resorbable fixation plate. This cranioplasty technique was designed to improve pressure on the fat graft to block the egress of CSF. Historic controls included 149 consecutive patients undergoing a translabyrinthine approach who were closed with fat cranioplasty only.

INTERVENTION

Resorbable plate cranioplasty versus fat graft cranioplasty.

MAIN OUTCOME MEASURES

Wound complication rate, incidence of postoperative CSF leak, treatment required, and length of hospitalization.

RESULTS

There were no surgical site infections in either group. The incidence of postoperative CSF leak was 12.7% (9/71) in the study group and 13.4% (20/149) in the controls (p = 0.88). There was no significant difference in the rate of lumbar drain placement or surgical revision requirement between the groups. There were no short- or long-term complications attributable to the placement of the plate, and additional operative time for the procedure averaged 7 minutes.

CONCLUSION

Cranioplasty with a resorbable plate after translabyrinthine craniotomy is safe. This technique results in a CSF leak rate equivalent to fat grafting alone.