Management and prevention of persistent cerebrospinal fluid otorrhea induced by lateral skull base surgery

Objective: To summarize the pathogenesis, operative management and prevention of persistent cerebrospinal fluid otorrhea induced by lateral skull base surgery.

Methods: Based on the primary diseases and operations, different surgeries for the otorrhea repair were performed as follows: three cases by the mastoidal approach; one case by post-aural combined with translabyrinthine approach; one case by post-aural combined with middle cranial fossaa access; two cases by retrosigmoidal approach; one case by the original incision approach.

Results: The leak locations were mastoidale in four cases, internal auditory meatus in three cases, external auditory meatus in three cases due to dural defect of middle cranial fossa and post-infra wall of external auditory meatus of one case. All cases were repaired successfully, including one case repaired twice.

Conclusions: Management and prevention of CSF otorrhea are different according to different skull base surgeries. Mastoid air cells should be focused for retrosigmoidal approach, internal auditory meatus for translabyrinthine approach, the repair of dura defect and closure of eustachium for total and subtotal petrosal removal.