Neuroendoscopic reconstructive approaches for the skull base defects of cerebrospinal fluid leakage in different grades: a comparative study

CHEN Weiliang; CHEN Xing; WANG Yuhai; YANG Likun; LI Peipei

Abstract：Objective The intra-operative cerebrospinal fluid leakage after the endoscopic endonasal surgery and the reconstruction method of the skull base were investigated and evaluated.Methods All ninety-five cases that were performed the operation from January 2012 to August 2015 were divided into three groups according to the degrees of intra-operative cerebrospinal fluid leakage,and the different reconstructive approaches were applied,and then the corresponding methods of skull base reconstruction were analyzed with regard to different intra-operative cerebrospinal fluid leakage.Results In 45 cases whose intra-operative cerebrospinal fluid leakage grade was 0,postoperative cerebrospinal fluid leakage was not found after undergoing three kinds of skull base reconstruction.Among 21 patients with intra-operative cerebrospinal fluid leakage of Grade 1,post-operative cerebrospinal fluid leakage incidence was 18.2％ (2/11) in mucosal flap reconstruction group and 10％ (1/10) in joint reconstruction group,respectively,which showed no statistical significance.In 29 cases with intra-operatie eerebrospinal fluid leakage of Grade 2,the incidence of post-operative cerebrospinal fluid leakage went as follows:there were 50％ (5/10) of mucosal flap reconstruction and 10.5％ (2/19) of joint reconstruction that demonstrated a significantly statistical difference.Conclnsion Different reconstruction approaches shotld be chosen according to different arachnoid damage degree.Reducing the complication of mucosal flap overuse and thigh injury can increase the comfort of patients and offer the convenience for the reseetion of recurrent tumors.