Cerebrospinal Fluid Diversion in Endoscopic Skull Base Reconstruction An Evidence-Based Approach to the Use of Lumbar Drains

被引:29
作者
Tien, Duc A. [1 ]
Stokken, Janalee K. [2 ]
Recinos, Pablo F. [1 ,3 ]
Woodard, Troy D. [1 ,3 ]
Sindwani, Raj [1 ,3 ]
机构
[1] Cleveland Clin, Head & Neck Inst, Sect Rhinol Sinus & Skull Base Surg, Cleveland, OH 44195 USA
[2] Mayo Clin, Dept Otolaryngol Head & Neck Surg, Rochester, MN 55905 USA
[3] Cleveland Clin, Minimally Invas Cranial Base & Pituitary Surg Pro, Rose Ella Burkhardt Brain Tumor & Neurooncol Ctr, Cleveland, OH 44195 USA
关键词
Endoscopic skull base reconstruction; Minimally invasive skull base surgery; Cerebrospinal fluid leak; Cerebrospinal fluid diversion; Lumbar drains; Subarachnoid drains; NASOSEPTAL FLAP; SURGERY; LEAKS; PUNCTURE; DEFECTS; REPAIR;
D O I
10.1016/j.otc.2015.09.007
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Before the vascularized pedicled nasoseptal flap was popularized, lumbar drains (LDs) were routinely used for cerebral spinal fluid (CSF) diversion in endoscopic skull base reconstruction. LDs are not necessary in most CSF leaks encountered during skull base surgery. The use of an LD is considered in select high-risk settings in which a high-flow leak is anticipated and the patient has significant risk factors that make closure of the leak more challenging. Evidence for the use of LDs in preventing postoperative after endoscopic skull base reconstruction is reviewed and a rational framework for their use is proposed.
引用
收藏
页码:119 / +
页数:12
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