Prevention of postoperative cerebrospinal fluid leaks after translabyrinthine tumor resection with resorbable mesh cranioplasty

Jacob B. Hunter, Alex D. Sweeney, Matthew L. Carlson, George B. Wanna, Alejandro Rivas, Kyle D. Weaver, Lola B. Chambless, Reid S. Thompson, David S. Haynes, Marc L. Bennett

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To evaluate the effectiveness of resorbable mesh cranioplasty at reducing postoperative cerebrospinal fluid (CSF) leak and pseudomeningocele formation after translabyrinthine tumor resection. Study Design: Case series with chart review. Setting: Tertiary academic referral center. Patients: Fifty-three consecutive cases using a resorbable mesh cranioplasty after translabyrinthine tumor resection were reviewed. Intervention: Temporal bone defects were repaired with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws. Main Outcome Measures: Primary outcome measures included the incidence of postoperative CSF wound leak or rhinorrhea, pseudomeningocele formation, and surgical site infection. Results: Fifty-three cases (average age, 54.0 yr; range, 19.3-75.1 yr) were analyzed. The average body mass index was 30.8 kg/m2 (range, 17.9-48.3 kg/m2), and the average tumor size was 18.8 mm (range, 8-38 mm). One patient (1.9%) experienced CSF rhinorrhea on postoperative Day 16, which resolved after transmastoid middle ear and eustachian tube packing. One patient (1.9%) experienced a surgical site infection requiring surgical debridement and mesh removal 4 months after surgery. Compared with 1,441 prior translabyrinthine surgeries analyzed from our institution using a traditional fat graft closure without mesh, the rate of postoperative CSF leak was significantly less using the resorbable mesh cranioplasty technique (p=0.0483). Conclusion: Resorbable mesh cranioplasty is a safe and effective method to reduce postoperative CSF leak and pseudomeningocele formation after translabyrinthine craniotomy for tumor excision.

Original languageEnglish (US)
Pages (from-to)1537-1542
Number of pages6
JournalOtology and Neurotology
Volume36
Issue number9
StatePublished - Jan 1 2015

Fingerprint

Cerebrospinal Fluid Rhinorrhea
Surgical Wound Infection
Neoplasms
Surgical Mesh
Fat Substitutes
Outcome Assessment (Health Care)
Transplants
Eustachian Tube
Temporal Bone
Craniotomy
Middle Ear
Debridement
Tertiary Care Centers
Body Mass Index
Fats
Cerebrospinal Fluid Leak
Incidence
Wounds and Injuries

Keywords

  • Acoustic neuroma
  • Resorbable mesh cranioplasty
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Hunter, J. B., Sweeney, A. D., Carlson, M. L., Wanna, G. B., Rivas, A., Weaver, K. D., ... Bennett, M. L. (2015). Prevention of postoperative cerebrospinal fluid leaks after translabyrinthine tumor resection with resorbable mesh cranioplasty. Otology and Neurotology, 36(9), 1537-1542.

Prevention of postoperative cerebrospinal fluid leaks after translabyrinthine tumor resection with resorbable mesh cranioplasty. / Hunter, Jacob B.; Sweeney, Alex D.; Carlson, Matthew L.; Wanna, George B.; Rivas, Alejandro; Weaver, Kyle D.; Chambless, Lola B.; Thompson, Reid S.; Haynes, David S.; Bennett, Marc L.

In: Otology and Neurotology, Vol. 36, No. 9, 01.01.2015, p. 1537-1542.

Research output: Contribution to journalArticle

Hunter, JB, Sweeney, AD, Carlson, ML, Wanna, GB, Rivas, A, Weaver, KD, Chambless, LB, Thompson, RS, Haynes, DS & Bennett, ML 2015, 'Prevention of postoperative cerebrospinal fluid leaks after translabyrinthine tumor resection with resorbable mesh cranioplasty', Otology and Neurotology, vol. 36, no. 9, pp. 1537-1542.
Hunter, Jacob B. ; Sweeney, Alex D. ; Carlson, Matthew L. ; Wanna, George B. ; Rivas, Alejandro ; Weaver, Kyle D. ; Chambless, Lola B. ; Thompson, Reid S. ; Haynes, David S. ; Bennett, Marc L. / Prevention of postoperative cerebrospinal fluid leaks after translabyrinthine tumor resection with resorbable mesh cranioplasty. In: Otology and Neurotology. 2015 ; Vol. 36, No. 9. pp. 1537-1542.
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abstract = "Objectives: To evaluate the effectiveness of resorbable mesh cranioplasty at reducing postoperative cerebrospinal fluid (CSF) leak and pseudomeningocele formation after translabyrinthine tumor resection. Study Design: Case series with chart review. Setting: Tertiary academic referral center. Patients: Fifty-three consecutive cases using a resorbable mesh cranioplasty after translabyrinthine tumor resection were reviewed. Intervention: Temporal bone defects were repaired with a dural substitute, layered fat graft, and a resorbable mesh plate secured with screws. Main Outcome Measures: Primary outcome measures included the incidence of postoperative CSF wound leak or rhinorrhea, pseudomeningocele formation, and surgical site infection. Results: Fifty-three cases (average age, 54.0 yr; range, 19.3-75.1 yr) were analyzed. The average body mass index was 30.8 kg/m2 (range, 17.9-48.3 kg/m2), and the average tumor size was 18.8 mm (range, 8-38 mm). One patient (1.9{\%}) experienced CSF rhinorrhea on postoperative Day 16, which resolved after transmastoid middle ear and eustachian tube packing. One patient (1.9{\%}) experienced a surgical site infection requiring surgical debridement and mesh removal 4 months after surgery. Compared with 1,441 prior translabyrinthine surgeries analyzed from our institution using a traditional fat graft closure without mesh, the rate of postoperative CSF leak was significantly less using the resorbable mesh cranioplasty technique (p=0.0483). Conclusion: Resorbable mesh cranioplasty is a safe and effective method to reduce postoperative CSF leak and pseudomeningocele formation after translabyrinthine craniotomy for tumor excision.",
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AU - Rivas, Alejandro

AU - Weaver, Kyle D.

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AU - Haynes, David S.

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