Risk factor for cerebrospinal fluid leak after endoscopic endonasal skull base surgery: a single-center experience.


Journal

Acta oto-laryngologica
ISSN: 1651-2251
Titre abrégé: Acta Otolaryngol
Pays: England
ID NLM: 0370354

Informations de publication

Date de publication:
Jun 2021
Historique:
pubmed: 19 3 2021
medline: 30 11 2021
entrez: 18 3 2021
Statut: ppublish

Résumé

One of the major complications in endoscopic endonasal skull base surgery (EESBS) is postoperative cerebrospinal fluid (CSF) leaks. Recently, EESBS has been applied to various skull base diseases as well as more complicated cases influenced by previous treatment with or without various comorbidities. This study aimed to assess the factors that influence the results of postoperative CSF leak after EESBS with mixed patient backgrounds. We conducted a retrospective analysis of the clinical records of patients undergoing EESBS in our institution from 2012 to 2017. Out of a total of 230 cases of EESBS, 11 (4.8%) suffered from postoperative CSF leakage. The rate of CSF leakage for pituitary adenoma, Rathke's cleft cyst, chordoma, and meningioma was 3.5%, 0%, 3.6% and 8.0%, respectively. Multiple variate analysis revealed that repeated surgery ( The rate of postoperative CSF leakage in this study was comparable to previous reports, and repeated surgery may increase postoperative CSF leakage. The surgical strategy for tumor removal as well as skull base reconstruction should be given careful consideration according to tumor pathology and the patient's condition.

Sections du résumé

BACKGROUND BACKGROUND
One of the major complications in endoscopic endonasal skull base surgery (EESBS) is postoperative cerebrospinal fluid (CSF) leaks. Recently, EESBS has been applied to various skull base diseases as well as more complicated cases influenced by previous treatment with or without various comorbidities.
AIMS/OBJECTIVES OBJECTIVE
This study aimed to assess the factors that influence the results of postoperative CSF leak after EESBS with mixed patient backgrounds.
MATERIALS AND METHODS METHODS
We conducted a retrospective analysis of the clinical records of patients undergoing EESBS in our institution from 2012 to 2017.
RESULTS RESULTS
Out of a total of 230 cases of EESBS, 11 (4.8%) suffered from postoperative CSF leakage. The rate of CSF leakage for pituitary adenoma, Rathke's cleft cyst, chordoma, and meningioma was 3.5%, 0%, 3.6% and 8.0%, respectively. Multiple variate analysis revealed that repeated surgery (
CONCLUSIONS AND SIGNIFICANCE CONCLUSIONS
The rate of postoperative CSF leakage in this study was comparable to previous reports, and repeated surgery may increase postoperative CSF leakage. The surgical strategy for tumor removal as well as skull base reconstruction should be given careful consideration according to tumor pathology and the patient's condition.

Identifiants

pubmed: 33733997
doi: 10.1080/00016489.2021.1900600
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

621-625

Auteurs

Hiroyuki Ozawa (H)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Mariko Sekimizu (M)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Shin Saito (S)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Shintaro Nakamura (S)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Takuya Mikoshiba (T)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Yoshihiro Watanabe (Y)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Yuichi Ikari (Y)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Masahiro Toda (M)

Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Japan.

Kaoru Ogawa (K)

Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Japan.

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