Document Detail


Case-specific protocol to reduce cerebrospinal fluid leakage after endonasal endoscopic surgery.
MedLine Citation:
PMID:  23724985     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Object Endoscopic transsphenoidal surgery is expanding in acceptance, yet postoperative CSF leak rates remain a concern. This study presents the Cornell closure protocol, which has yielded significantly lower postoperative CSF leak rates compared with prior reports, as an algorithm that can be used by centers having difficulty with CSF leak. Methods A single closure algorithm for endoscopic surgery has been used since January 2010 at Weill Cornell Medical College. A prospective database noting intraoperative CSF leak, closure technique, and postoperative CSF leak was reviewed. The authors used a MEDLINE search to identify similar studies and compared CSF leak rates to those of patients treated using the Cornell algorithm. Results The retrospective study of a prospectively acquired database included 209 consecutive patients. In 84 patients (40%) there was no intraoperative CSF leak and no postoperative CSF leak. In the 125 patients (60%) with an intraoperative CSF leak, 35 of them with high-flow leaks, there were 0 (0%) postoperative CSF leaks. Conclusions It is possible to achieve a CSF leak rate of 0% by using this closure protocol. With proper experience, endoscopic skull base surgery should not be considered to have a higher CSF leak rate than open transcranial or microscopic transsphenoidal surgery.
Authors:
Kunal S Patel; Ricardo J Komotar; Oszkar Szentirmai; Nelson Moussazadeh; Daniel M Raper; Robert M Starke; Vijay K Anand; Theodore H Schwartz
Related Documents :
23108085 - Laparoscopic spleen-preserving distal pancreatectomy (lspdp).
24136755 - Robotic surgery in cardiology: a safe and effective procedure.
23436085 - Aortic injury during laparoscopic esophageal hiatoplasty.
23422805 - Initial results of minimally invasive ivor lewis esophagectomy after induction chemorad...
23743745 - Long-term outcomes of endoscopic sinus surgery for chronic rhinosinusitis with and with...
12593365 - Streamlining the preoperative process for the open heart surgery patient.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-31
Journal Detail:
Title:  Journal of neurosurgery     Volume:  -     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-6-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Neurosurgery.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Hypoglossal canal dural arteriovenous fistula: incidence and the relationship between symptoms and d...
Next Document:  Accuracy of deep brain stimulation electrode placement using intraoperative computed tomography with...