CEREBROSPINAL-FLUID (CSF) OTORHINORRHOEA FOLLOWING VESTIBULAR SCHWANNOMA SURGERY TREATED BY EXTENDED SUBTOTAL PETROSECTOMY WITH OBLITERATION

Extended subtotal petrosectomy as a treatment for persistent cerebrosp inal fluid (CSF) otorhinorrhoea is presented. Four patients were succe ssfully operated on by this technique, all previously having undergone suboccipital removal of vestibular schwannoma: other interventions us ed had failed to seal the fistulae. The internal auditory canal was th e usual pathway for CSF leakage as well as retrosigmoid, retrolabyrint hine, retro- or perifacial cells. Total exenteration of middle ear and mastoid cell tracts, skeletonization of sigmoid sinus, jugular bulb a nd facial nerve. drilling out of semicircular canals, vestibule, and c ochlea, and skeletonization of the internal auditory canal, followed b y obliteration, are the main steps of this approach.