Tips for Preventing Cerebrospinal Fluid Rhinorrhea after Acoustic Neurinoma Surgery: Technical Note

Abstract CSF rhinorrhea is a common complication of acoustic neurinoma surgery via the suboccipital route. In this paper we present our incidence of CSF rhinorrhea and our surgical techniques for reducing the risk of this post-surgical complication. Following removal of the acoustic neurinoma, the d...

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Bibliographic Details
Published in:Skull base 1998, Vol.8 (4), p.181-183
Main Authors: Date, Isao, Asari, Shoji, Ohmoto, Takashi
Format: Article
Language:English
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Summary:Abstract CSF rhinorrhea is a common complication of acoustic neurinoma surgery via the suboccipital route. In this paper we present our incidence of CSF rhinorrhea and our surgical techniques for reducing the risk of this post-surgical complication. Following removal of the acoustic neurinoma, the drilled posterior wall of the internal auditory canal is covered with bonewax, muscle or fat pieces, and fibrin-glue, while the previously reflected dura is sutured in place keeping the packing material in position. Bone chips removed during the craniectomy are then mixed with fibric glue and are used for a cranioplasty. Although we routinely perform aggressive drilling of internal auditory canal to facilitate total removal of the acoustic neurinoma, only 1 out of 94 consecutive cases (1%) showed postoperative CSF rhinorrhea. Since previous reports mention the rate of this complication following acoustic neurinoma surgery varies between 4% and 27%, we believe that our methods may be useful in helping reduce the incidence of postoperative rhinorrhea.
ISSN:1052-1453
1531-5010
1098-9072
1532-0065
DOI:10.1055/s-2008-1058180