Abstract
For the prevention of cerebrospinal fluid fistula (CSF) after vestibular schwannoma surgery a meticulous sealing of opened air cells in the skull base bone is necessary. To find out whether muscle or fat tissue is superior for this purpose, we performed a retrospective analysis. Four hundred and twenty patients between January 2001 and December 2006 had a retrosigmoidal microsurgical removal in a standardized procedure. Opened air cells at the inner auditory canal and the mastoid bone were sealed with muscle in 283 patients and in 137 patients with fat tissue. Analysis was performed regarding the incidence of postoperative CSF fistula and correlation with the patient’s tumor grade and sex. The incidence of postoperative CSF leak after application of fat tissue was lower (2.2%) than after usage of muscle (5.7%). Women suffered less from postoperative CSF leaks (3.4%) than men (5.6%). With the tumor grade we found an inverse correlation. Patients with smaller tumors seemed to have a higher rate of CSF leak than patients with large tumors without hydrocephalus. Only large tumors with severe dislocation of the brainstem and hydrocephalus showed a higher rate of CSF-leaks. Fat implant is superior to muscle implant for the prevention of CSF leak after vestibular schwannoma surgery, and should be used for the sealing of opened air cells in skull base surgery.
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Lüdemann, W.O. (2012). Vestibular Schwannoma Surgery: Use of Fat Implant to Prevent Cerebrospinal Fluid Fistula. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 7. Tumors of the Central Nervous System, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2894-3_33
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DOI: https://doi.org/10.1007/978-94-007-2894-3_33
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