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

作　　者：Matthew W.Cooper Bryan K.Ward Jeffery Sharon Howard W.Francis 

机构地区：[1]Department of Head and Neck Surgery Et Communication Sciences,Duke University School of Aied/c/ne,Durham,NC,L/SA [2]Department of Otolarynsolosy-Head and Neck Surgery,Johns Hopkins University School of Medicine,Baltimore,MD,USA [3]Department of Otolaryngology-Head and Neck Surgery,University of California San Francisco,San Francisco,CA,USA

出　　处：《World Journal of Otorhinolaryngology-Head and Neck Surgery》2021年第2期82-87,共6页世界耳鼻咽喉头颈外科杂志（英文）

摘　　要：Objective:To describe the procedure and results of an adapted closure and recon struction 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.

关 键 词：Translabyrinthine approach Cerebrospinal fluid leak RHINORRHEA Air cell tract Petrous apex Eustachian tube Hydroxyapatite cement 

分 类 号：R765.24[医药卫生—耳鼻咽喉科]