Cerebrospinal fluid (CSF) leakage remains an important complication following translabyrinthine schwannoma surgery, with reported rates ranging from 0.8 % to 30 % in contemporary series. We describe a sequentially refined closure protocol developed to address the main CSF egress pathways.
✦ The floor
Discussion
Signed responses from readers of the wire.
Skull-base surgeons performing translabyrinthine vestibular schwannoma resection may consider this suture-stabilised fat graft combined with improved Eustachian tube obliteration as a refinement to reduce CSF leak rates, though the evidence is limited to a technical case series.
CSF leaks remain one of the most common and serious complications of translabyrinthine surgery, so reproducible technical refinements that demonstrably lower leak rates have direct value for surgical teams.
- 01Technical note presents a suture-stabilised fat graft method to reduce CSF leaks post-translabyrinthine surgery.
- 02Improved Eustachian tube obliteration is paired with the fat graft technique.
- 03Leak rates reportedly reduced progressively as the technique was adopted.
- 04Evidence is limited to a technical note / case series level — no randomised comparison.
- 05Findings most relevant to neurotological and skull-base surgical teams.
A suture-stabilised fat graft combined with improved Eustachian tube obliteration progressively reduces CSF leak rates in translabyrinthine vestibular schwannoma surgery.
studypartially supported- PMID
- 42994162
- DOI
- 10.1016/j.jocn.2026.112379.
- Journal
- Journal of Clinical Neuroscience
- Publication type
- technical_note
- Evidence level
- 4
- Population
- Patients undergoing translabyrinthine vestibular schwannoma surgery
- Intervention
- Suture-stabilised fat graft with improved Eustachian tube obliteration
Primary outcomes
CSF leak rate; Surgical complication rate