Related Factors Of Cerebrospinal Fluid Leakage In Acoustic Neuroma Surgery

Objective Investigation of the related factors of cerebrospinal fluid(CSF)leakage in Acoustic neuroma(vestibular schwannoma vs)surgery,and to help neurosurgeons to adopt appropriate treatment plan during perioperative period to achieve the goal of reducing postoperative CSF leakage.Methods From June 2014 to January 2017,90 patients who underwent retrosigmoid approach acoustic neuroma(AN)microsurgery were retrospectively analyzed,including 1 case of postoperative death,1 cases of secondary surgery patients,32 cases of male,female 56 cases,sex ratio of 1:1.8,aged 21 to 76 years old,average 49.9 years,Microscopic resection of the tumor was performed under facial nerve monitoring.Compared with auditory neuropathy,patients with CSF leakage And the patents absence of CSF leakage in patients with age,sex,tumor size,location of the tumor,whether the recurrence of the tumor,whether the internal auditory canal(IAC)expansion preoperatively,the degree of gasification of the petrosum,intraoperative removal of the IAC wall,operative time,combined with diabetes,Body Mass Index(BMI)and other factors,retrospectively analysis of patients with AN microsurgery after CSF leakage related factors.Results Multivariate Logistic regression analysis was performed for all factors considered,only the intraoperative examination of the posterior wall of the IAC(OR 3.58,95%CI 1.022~12.536;P= 0.046),the operative time(OR 1.008,95%CI1.001~1.016;P= 0.029)and the course of the disease(OR 1.011,95%CI 1.001~1.023;P= 0.040)were statistically significant.And there were 19 cases of CSF leakage(22%)in this study,including 12 cases of CSF rhinorrhea,6 cases of incision leakage and 1 case of ear leakage.Conclusion There are many factors affecting the CSF leakage in AN surgery.The related factors in this study include: The posterior wall of the IAC is drilled、the operative time and course of the disease.However,this study is a single center study,and there are few cases in the group,which need to be further confirmed.