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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

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