Cerebrospinal Fluid ‘Leaks’ and Meningitis following Acoustic Tumor Surgery

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Abstract
Of 271 intracanalicular and cerebellopontine angle lesions removed over the past 10 yr, 237 were removed by the translabyrinthine or combined approach which created a mastoid defect. The patients were divided into 3 groups with the following results: obliteration of the mastoid defect combined with older wound closure techniques in the 1st 188 patients produced CSF leakage in 25% and meningitis in 16% of cases. Not obliterating the defect intentionally in 16 patients produced CSF leakage in 50% and meningitis in 25% of cases. Obliteration of the defect combined with newer packing and closure techniques in the last 33 patients produced CSF leakage and meningitis in only 6% of cases. Four problem areas were identified: the eustachian tube, middle ear, mastoid defect and postauricular wound. Of these, obliteration of the mastoid defect was most important in minimizing postoperative CSF wound leakage, CSF rhinorrhea and meningitis.

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