Factors associated with cerebrospinal fluid leak after a retrosigmoid approach for cerebellopontine angle surgery

xlomafota13 shared this article with you from Inoreader Factors associated with cerebrospinal fluid leak after a retrosigmoid approach for cerebellopontine angle surgery Via leak of cerebrospinal fluid Surg Neurol Int. 2021 Jun 7;12:258. doi: 10.25259/SNI_42_2021. eCollection 2021. ABSTRACT BACKGROUND: The retrosigmoid approach represents a crucial surgical route to address different lesions in the cerebellopontine angle but cerebrospinal fluid (CSF) leak still remains the most frequent complication after this approach. Here, we analyzed the impact of different factors in CSF leak development after a retrosigmoid approach. Identifying risk factors related to a specific approach may help the surgeon to tailor the perioperative management and to appropriately counsel patients regarding their risk profile. METHODS: We retrospectively reviewed the clinical, surgical, and outcome data of 103 consecutive patients (M/F, 47/56; mean follow-up 35.6 ± 23.9 months) who underwent a retrosigmoid approach for different cerebellopontine angle pathologies and studied the impact of different factors on the occurrence of a CSF leak to univariate and m ultivariate analysis. RESULTS: Seventy-nine patients (76.7%) were operated for tumors growing in the cerebellopontine angle. Twenty-four patients (23.2%) underwent microvascular decompression to treat a drug-resistant trigeminal neuralgia. Sixteen patients (15.5%) developed CSF leak in the postoperative course of which six underwent surgical revision. Performing a craniectomy as surgical procedure (P = 0.0450) and performing a reopening procedure (second surgery; P = 0.0079) were significantly associated to a higher risk of developing CSF leak. Moreover, performing a reopening procedure emerged as an independent factor for CSF developing on multivariate analysis (P = 0.0156). CONCLUSION: Patients submitted to craniectomy and patients who underwent a second surgery showed an higher CSF leak rate. Ongoing improvement of biomaterial technology may help neurosurgeons to prevent this potentially life-threatening complication. PMID:34221589 | PMC:PMC8247722 | DOI:10.25259/SNI_42_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.