Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.
Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Japan.
Acta Otolaryngol. 2021 Jun;141(6):621-625. doi: 10.1080/00016489.2021.1900600. Epub 2021 Mar 18.
One of the major complications in endoscopic endonasal skull base surgery (EESBS) is postoperative cerebrospinal fluid (CSF) leaks. Recently, EESBS has been applied to various skull base diseases as well as more complicated cases influenced by previous treatment with or without various comorbidities.
AIMS/OBJECTIVES: This study aimed to assess the factors that influence the results of postoperative CSF leak after EESBS with mixed patient backgrounds.
We conducted a retrospective analysis of the clinical records of patients undergoing EESBS in our institution from 2012 to 2017.
Out of a total of 230 cases of EESBS, 11 (4.8%) suffered from postoperative CSF leakage. The rate of CSF leakage for pituitary adenoma, Rathke's cleft cyst, chordoma, and meningioma was 3.5%, 0%, 3.6% and 8.0%, respectively. Multiple variate analysis revealed that repeated surgery ( = .008) and intraoperative CSF leak ( = .044) were significant risk factors for postoperative CSF leakage.
The rate of postoperative CSF leakage in this study was comparable to previous reports, and repeated surgery may increase postoperative CSF leakage. The surgical strategy for tumor removal as well as skull base reconstruction should be given careful consideration according to tumor pathology and the patient's condition.
内镜经鼻颅底手术（EESBS）的主要并发症之一是术后脑脊液（CSF）漏。最近，EESBS 已应用于各种颅底疾病以及受先前治疗影响的更复杂病例，这些病例有或无各种合并症。
目的/目标：本研究旨在评估混合患者背景下 EESBS 后 CSF 漏的影响因素。
我们对 2012 年至 2017 年在我院行 EESBS 的患者的临床记录进行了回顾性分析。
在总共 230 例 EESBS 中，有 11 例（4.8%）发生术后 CSF 漏。垂体腺瘤、Rathke 裂囊肿、脊索瘤和脑膜瘤的 CSF 漏发生率分别为 3.5%、0%、3.6%和 8.0%。多变量分析显示，重复手术（ = .008）和术中 CSF 漏（ = .044）是术后 CSF 漏的显著危险因素。
本研究中术后 CSF 漏的发生率与以往报道相当，重复手术可能增加术后 CSF 漏的风险。根据肿瘤病理和患者情况，应仔细考虑肿瘤切除和颅底重建的手术策略。
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