CEREBROSPINAL-FLUID LEAK MANAGEMENT FOLLOWING CEREBELLOPONTINE ANGLE SURGERY

Objective: Postoperative cerebrospinal fluid leak (CSF) is a serious c omplication of the cerebellopontine angle surgery. In the current lite rature, CSF leak rates vary from 8.1 to 20%. The various options in ma naging this troublesome complication include conservative treatment or invasive surgical repair. The focus of this report is to retrospectiv ely analyze our experience on this specific topic reviewing the incide nce of CSF leak and the outcomes of its treatment in a group of patien ts who underwent surgery for different pathology of the cerebelloponti ne angle. Method: Eighty-five patients who underwent primary surgical procedures performed by a single neurologist were selected for this st udy. There were 70 surgical removals of acoustic neuromas, and 15 othe r cerebellopontine lesions. Results: The overall incidence of CSF leak in the total group analyzed was 17.6%. There were five CSF rhinorrhea s and 10 wound CSF leaks. Ten acoustic neuromas and five other cerebel lopontine angle lesions exhibited this complication. The leak was cure d in 53.3% of the cases using a continuous lumbar cerebrospinal fluid drainage (CLCFD). In two patients, the leak was treated with an extrad ural repair. Conclusions: Although CLCFD is not routinely used in the treatment of the CSF leak, it proved to be an efficacious and safe opt ion, confirmed by no meningitis observed in our patients treated with this method.