Eustachian Tube Obliteration and its Effect on Rhinoliquorrhea in Translabyrinthine Vestibular Schwannoma Excision

J Int Adv Otol. 2017 Aug;13(2):191-194. doi: 10.5152/iao.2017.3764.

Abstract

Objective: Rhinoliquorrhea is defined as a cerebrospinal fluid leakage from the nose. Our objective in this study is to determine the reduction of rhinoliquorrhea rates by Eustachian tube (ET) obliteration in the context of a translabyrinthine approach performed following vestibular schwannoma (VS) excision.

Materials and methods: This is a prospective study achieved in a tertiary-care center where the chart review revealed 94 VS operated by the translabyrinthine approach between 2009 and 2015. There were 40 males and 54 females aged from 28-76 years. The only exclusion criterion was a previous history of cranial surgery. ET obliteration was systematically executed when the petrous apex pneumatization level was at least 2 of 4. Our main outcome measure was the development of rhinoliquorrhea.

Results: Eighty-eight patients underwent ET obliteration and were followed for an average of 2.6±1.2 years. Rhinoliquorrhea was reported in 1.14% of the patients having had an ET obliteration. When compared to our previous sample of patients operated with a translabyrinthine approach, it represents a reduction of 84%.

Conclusion: Obliteration of the ET is a fast and simple procedure that reduces the rate of rhinoliquorrhea. We therefore recommend its use, specifically in cases of petrous apex pneumatization levels 2-4.

MeSH terms

  • Adult
  • Aged
  • Cerebrospinal Fluid Leak / etiology*
  • Cerebrospinal Fluid Leak / prevention & control
  • Ear, Inner
  • Eustachian Tube / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Microsurgery / adverse effects*
  • Microsurgery / methods*
  • Middle Aged
  • Neuroma, Acoustic / surgery*
  • Postoperative Complications
  • Prospective Studies