Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa

Objective: To describe the procedure and results of an adapted closure and reconstruction technique for translabyrinthine surgery that focuses on identifying and managing potential pathways for CSF egress to the middle ear and Eustachian tube. Methods: Retrospective review of a cohort of translabyri...

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Autores principales:	Matthew W. Cooper, Bryan K. Ward, Jeffery Sharon, Howard W. Francis
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2021
Materias:	Translabyrinthine approach Cerebrospinal fluid leak Rhinorrhea Air cell tract Petrous apex Eustachian tube Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d62759a61a4c427e93586312931ab474
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spelling	oai:doaj.org-article:d62759a61a4c427e93586312931ab4742021-12-02T18:26:43ZReducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa2095-881110.1016/j.wjorl.2021.01.003https://doaj.org/article/d62759a61a4c427e93586312931ab4742021-04-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881121000160https://doaj.org/toc/2095-8811Objective: To describe the procedure and results of an adapted closure and reconstruction technique for translabyrinthine surgery that focuses on identifying and managing potential pathways for CSF egress to the middle ear and Eustachian tube. Methods: Retrospective review of a cohort of translabyrinthine acoustic neuroma cases that were reconstructed using this technique. Results: In addition to meticulous packing of potential conduits using soft tissue, hydroxyapatite cement is used to seal opened air cell tracts prior to obliteration of the mastoid defect using adipose tissue. Early results of a small patient cohort using this technique are encouraging and there were no wound infections. There was a single case of CSF rhinorrhea associated with incomplete sealing of opened petrous apex cells, with no recurrence after appropriate implementation of the described protocol during revision surgery. Conclusion: Proactive management of potential conduits of CSF egress including opened air cell tracts has a high likelihood of reducing rates of rhinorrhea and need for revision surgery after the translabyrinthine approach to the posterior fossa.Matthew W. CooperBryan K. WardJeffery SharonHoward W. FrancisKeAi Communications Co., Ltd.articleTranslabyrinthine approachCerebrospinal fluid leakRhinorrheaAir cell tractPetrous apexEustachian tubeOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 7, Iss 2, Pp 82-87 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Translabyrinthine approach Cerebrospinal fluid leak Rhinorrhea Air cell tract Petrous apex Eustachian tube Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Translabyrinthine approach Cerebrospinal fluid leak Rhinorrhea Air cell tract Petrous apex Eustachian tube Otorhinolaryngology RF1-547 Surgery RD1-811 Matthew W. Cooper Bryan K. Ward Jeffery Sharon Howard W. Francis Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
description	Objective: To describe the procedure and results of an adapted closure and reconstruction technique for translabyrinthine surgery that focuses on identifying and managing potential pathways for CSF egress to the middle ear and Eustachian tube. Methods: Retrospective review of a cohort of translabyrinthine acoustic neuroma cases that were reconstructed using this technique. Results: In addition to meticulous packing of potential conduits using soft tissue, hydroxyapatite cement is used to seal opened air cell tracts prior to obliteration of the mastoid defect using adipose tissue. Early results of a small patient cohort using this technique are encouraging and there were no wound infections. There was a single case of CSF rhinorrhea associated with incomplete sealing of opened petrous apex cells, with no recurrence after appropriate implementation of the described protocol during revision surgery. Conclusion: Proactive management of potential conduits of CSF egress including opened air cell tracts has a high likelihood of reducing rates of rhinorrhea and need for revision surgery after the translabyrinthine approach to the posterior fossa.
format	article
author	Matthew W. Cooper Bryan K. Ward Jeffery Sharon Howard W. Francis
author_facet	Matthew W. Cooper Bryan K. Ward Jeffery Sharon Howard W. Francis
author_sort	Matthew W. Cooper
title	Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
title_short	Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
title_full	Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
title_fullStr	Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
title_full_unstemmed	Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
title_sort	reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa
publisher	KeAi Communications Co., Ltd.
publishDate	2021
url	https://doaj.org/article/d62759a61a4c427e93586312931ab474
work_keys_str_mv	AT matthewwcooper reducingtheriskofcerebrospinalfluidrhinorrheafollowingtranslabyrinthinesurgeryoftheposteriorfossa AT bryankward reducingtheriskofcerebrospinalfluidrhinorrheafollowingtranslabyrinthinesurgeryoftheposteriorfossa AT jefferysharon reducingtheriskofcerebrospinalfluidrhinorrheafollowingtranslabyrinthinesurgeryoftheposteriorfossa AT howardwfrancis reducingtheriskofcerebrospinalfluidrhinorrheafollowingtranslabyrinthinesurgeryoftheposteriorfossa
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Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa

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