Related Factors Of Cerebrospinal Fluid Leakage After Retrosigmoid Approach For Vestibular Schwannoma

Objective: This study explored the relevant factors of cerebrospinal fluid leakage after vestibular schwannomas.The purpose is to help neurosurgeon clinicians to adopt appropriate treatment plan and postoperative clinical management to achieve the possible reduction of cerebrospinal fluid leakage after vestibular schwannomas.The probability of occurrence.Methods: A retrospective analysis of 132 patients with vestibular schwannomas admitted to our department from January 2016 to December 2018,including 51 males and 81 females,with a sex ratio of 1:1.6 and an average age of 23 to 76 years.52.8 years old,all patients underwent suboccipital sigmoid sinus approach,microscopic tumor resection under facial nerve monitoring,comparison of patients with cerebrospinal fluid leakage after vestibular schwannomas and patients without cerebrospinal fluid leakage,tumor size,length of disease,tumor recurrence,preoperative orthotopic enlargement,degree of mastoid gasification,intraoperative removal of the posterior wall of the auditory canal,presence of diabetes,body mass index(BMI),and clinical management And the experience of the surgeon,etc.,to analyze the influencing factors of postoperative cerebrospinal fluid leakage in patients with vestibular schwannomas.Results: Multivariate logistic regression analysis was performed for each factor considered,and cerebrospinal fluid leakage rate was observed every year for three years.In this study,there were 10 patients with cerebrospinal fluid leakage(7.5%),including 8 cases of cerebrospinal fluid rhinorrhea and 1 case of incision leakage.1 case of ear leak.Intraoperative removal of the posterior wall of the internal auditory canal(OR 5.037,95% CI 1.202 to 34.290;P = 0.029)was statistically different.In this study,10 patients had cerebrospinal fluid leakage(7.5%)after operation,including 8 cases of cerebrospinal fluid rhinorrhea,1 case of incision leakage,and 1 case of ear leak.According to the year,it was 11.1%(5/45)in 2016,6.98%(3/43)in 2017,and 4.55%(2/44)in 2018.Conclusion: There are many factors affecting cerebrospinal fluid leakage after vestibular schwannomas,which is related to whether or not to remove internal auditory canal,clinical management,and surgeon experience.This study is a single-center study,and the number of enrolled cases is relatively small,and its conclusion needs further confirmation.