Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-23T04:13:38.575Z Has data issue: false hasContentIssue false

Cerebrospinal fluid (CSF) otorhinorrhoea following vestibular schwannoma surgery treated by extended subtotal petrosectomy with obliteration

Published online by Cambridge University Press:  29 June 2007

Jona Kronenberg*
Affiliation:
Departments of Otorhinolaryngology–Head and Neck Surgery, The Chaim Sheba Medical Center and the Tel-Aviv University Sackler School of Medicine, Tel-Hashomer, Israel
Erez Bendet
Affiliation:
Departments of Otorhinolaryngology–Head and Neck Surgery, The Chaim Sheba Medical Center and the Tel-Aviv University Sackler School of Medicine, Tel-Hashomer, Israel
Gideon Findler
Affiliation:
Departments of Otorhinolaryngology–Head and Neurosurgery The Chaim Sheba Medical Center and the Tel-Aviv University Sackler School of Medicine, Tel-Hashomer, Israel
Yehudah Roth
Affiliation:
Departments of Otorhinolaryngology–Head and Neck Surgery, The Chaim Sheba Medical Center and the Tel-Aviv University Sackler School of Medicine, Tel-Hashomer, Israel
*
Dr Kronenberg, Department of Otorhinolaryngology–Head and Neck Surgery, The Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel

Abstract

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

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Coker, N., Jenkins, H. A., Fisch, U. (1986) Obliteration of the middle ear and mastoid cleft in subtotal petrosectomy: indications, technique and results. Annals of Otology, Rhinology and Laryngology 95:511CrossRefGoogle ScholarPubMed
Ferrante, L., Paltinsky, E., Acqui, M., Mastronardi, L. (1988) Endaural extracranial repair for cerebrospinal otorrhoea with human fibrin glue: technical note. Journal of Neurology. Neurosurgery and Psychiatry 51:14381440CrossRefGoogle ScholarPubMed
Fisch, U., Pillsbury, H. C. (1979) Infratemporal fossa approach to lesions in the temporal bone and base of skull. Archives ofOtolaryngology 105:99107CrossRefGoogle Scholar
Gacek, R. R. (1976) Mastoid and middle ear cavity obliteration for control of otitis media. Annals of Otology, Rhinology and Laryngology 85:305309CrossRefGoogle ScholarPubMed
Glasscock, M. E., Hays, J. W., Jackson, C. G. (1978) A one-stage combined approach for the management of large cerebellopontine angle tumors. Laryngoscope 88:15631576CrossRefGoogle ScholarPubMed
Harner, S., Laws, E. R. (1982) Translabyrinthine repair for cerebrospinal fluid otorrhoea. Journal of Neurosurgery 57:258261CrossRefGoogle Scholar
Hicks, G. W., Wright, J. W. Jr., Wright, J. W. 3rd (1980) Cerebrospinal fluid otorrhoea. Laryngoscope 90 (suppl. 25): 125CrossRefGoogle Scholar
Myers, D. L., Sataloff, R. T. (1984) Spinal fluid leakage after skull base surgical procedures Otolaryngology Clinics of North America 17:601612Google Scholar
Solomons, N. B., Robinson, J. M. (1988) Obliteration of mastoid using bone paté. Journal of Laryngology and Otology 102:783784CrossRefGoogle ScholarPubMed
Swanson, S. E., Chandler, W. E., Kochan, M. J., Bogdasarian, R. S. (1985) Flow-regulated continuous spinal drainage in the management of cerebrospinal fluid fistulas. Laryngoscope 95:104106Google ScholarPubMed
Walker, A. E. (1956) Cerebrospinal fluid rhinorrhoea following removal of an acoustic neuroma. Journal of Neurosurgery 13:199204CrossRefGoogle ScholarPubMed
Watanabe, E., Saito, I., Tanishima, T., Iwamura, S., Komatsuzaki, A.(1979) Intramastoid packing for CSF rhinorrhoea following acoustic neurinoma removal. Surgical Neurology 11:309311Google ScholarPubMed
Wetmore, S. J., Herman, P., Fisch, U. (1987) Spontaneous cerebrospinal fluid otorrhoea. American Journal of Otology 8:96102Google Scholar