Objective : In various skull base approaches, the risk of cerebrospinal fluid (CSF) leakage
exists and the leakage may lead to a life-threatening condition such as meningoencephalitis.
The incidence of its occurrence varies in previous literatures and the management dealing
the leakage was not established. In this study, we reviewed our experiences dealing CSF
leakage after a skull base surgery and suggest a guideline of managing CSF leakage.
Patients and Methods : From 2001 to 2007, 273 patients who underwent skull base surgery
for managing tumor were reviewed retrospectively. The charts were analyzed for the date of
surgery, age and sex of the patient, the presence or absence of CSF leak, and when
present, its managements.
Results : Among the 273 patients, six patients had CSF leakage after surgery. The incidence
of CSF leakage in this series was 2.19%. The risk of CSF leakage was highest in the
retrosigmoid and combined approaches (3.03%). Two of these patients with CSF leakage
developed bacterial meningitis, and these two patients with meningitis were treated with
intravenous antibiotics. Among the six patients, the CSF leakage had improved without a
direct surgical repair of dural defect in four patients; the others underwent a surgical repair.
Conclusions : Our results indicate that postoperative CSF leakage can be managed activity
restriction, and lumbar-subarachnoid drainage, but in case of refractory leakage, wound
revision and surgical dural defect repair enables the patients to reduce hospital days and
further complications.