ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2022
Prevention of cerebrospinal fluid leak after vestibular schwannoma surgery: a case-series focus on mastoid air cells' partition.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Cerebrospinal fluid leakage in patients after retrosigmoid approach for tumor resection: systematic review of techniques to manage dural closure and cranial reconstruction.Neurosurgical review · 2025Pooled it
- Evaluating the effectiveness and complications of the Retrosigmoid, Translabyrinthine and Middle Fossa approaches in vestibular Schwannoma surgical management: a comprehensive systematic review and meta-analysis of 6,889 patients.Neurosurgical review · 2025Pooled it
- A Stitch in Time Saves Nine: Retrosigmoid Craniotomy with Layered Suboccipital Muscle Dissection to Prevent Cerebrospinal Fluid Leak and Infection.Journal of neurological surgery. Part B, Skull base · 2026Article
- Reducing cerebrospinal fluid leak in vestibular schwannoma surgery via a retrosigmoid approach: a retrospective clinical study.Acta neurochirurgica · 2025Article
- Characterization of jugular bulb position on computed tomography (CT) with implications for excision of vestibular schwannomas.Neurosurgical review · 2025Article
- Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 2: The Translabyrinthine Approach).Journal of neurological surgery. Part B, Skull base · 2024Article
- Skull Base Repair following Resection of Vestibular Schwannoma: A Systematic Review (Part 1: The Retrosigmoid Approach).Journal of neurological surgery. Part B, Skull base · 2024Article
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8 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPetrous bone pneumatization may be related to cerebrospinal fluid (CSF) leak secondary to vestibular schwannoma surgery.
objectiveTo assess the association between petrous bone pneumatization and CSF leak in vestibular schwannoma surgery.
methodsA retrospective study included 222 consecutive vestibular schwannoma patients treated via a retrosigmoid or translabyrinthine approach in a 17-year period in one University Hospital. Association of CSF leak and petrous bone pneumatization, as seen on CT scans, was assessed on ANOVA and Student's t or Chi-squared test in case of non-parametric distribution.
resultsOne hundred and 75 resections were performed on a retrosigmoid approach and 47 on a translabyrinthine approach. Mean age was 53.6 ± 12.9 years. Mean follow-up was 5 years 6 months. Twenty-six patients (11.7%) showed CSF leak and 8 (3.6%) meningitis. Approach (p = 0.800), gender (p = 0.904), age (p = 0.234), body-mass index (p = 0.462), tumor stage (p = 0.681) and history of schwannoma surgery (p = 0.192) did not increase the risk of CSF leak. This risk was unrelated to mastoid pneumatization (p = 0.266). There was a highly significant correlation between internal acousticus meatus (IAM) posterior wall pneumatization and CSF leak after retrosigmoid surgery (p = 0.008). Eustachian tube packing in the translabyrinthine approach did not decrease risk of CSF leak (p = 0.571).
conclusionDegree of petrous bone pneumatization was not significantly related to risk of CSF leak, but pneumatization of the posterior IAM wall increased this risk in retrosigmoid surgery. Eustachian tube packing in the translabyrinthine approach is not sufficient to prevent postoperative CSF leak. Both approaches had similar rates of CSF leaks, around 12%.
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