Accepted Manuscript Combined Use of a Gasket Seal Closure and a VP-NSF Multilayered Reconstruction Technique for High-flow CSF Leaks After Endonasal Endoscopic Skull Base Surgery Fan Hu , MD Ye Gu , MD Xiaobiao Zhang , MD Tao Xie , MD Yong Yu , MD, PhD Chongjing Sun , MD Wensheng Li , PhD PII:
S1878-8750(14)00547-6
DOI:
10.1016/j.wneu.2014.06.004
Reference:
WNEU 2394
To appear in:
World Neurosurgery
Received Date: 23 August 2013 Revised Date:
31 October 2013
Accepted Date: 3 June 2014
Please cite this article as: Hu F, Gu Y, Zhang X, Xie T, Yu Y, Sun C, Li W, Combined Use of a Gasket Seal Closure and a VP-NSF Multilayered Reconstruction Technique for High-flow CSF Leaks After Endonasal Endoscopic Skull Base Surgery, World Neurosurgery (2014), doi: 10.1016/ j.wneu.2014.06.004. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Hu
ACCEPTED MANUSCRIPT
Combined Use of a Gasket Seal Closure and a VP-NSF Multilayered Reconstruction Technique for High-flow CSF Leaks After Endonasal Endoscopic Skull Base Surgery
Corresponding author: Xiaobiao Zhang
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(MD, PhD)1, Chongjing Sun (MD)1, Wensheng Li (PhD)3
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Fan Hu (MD)1,2, Ye Gu (MD)1, Xiaobiao Zhang (MD)1,2, Tao Xie (MD)3, Yong Yu
Road Shanghai, PR China, 200032;
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1 Department of Neurosurgery at Zhongshan Hospital, Fudan University, 180 Fenglin
2 Shanghai Key Lab of Medical Image Computing and Computer Assisted Intervention, Shanghai, PR China;
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3 Department of Anatomy/Digital Medical Research Center, Shanghai Medical College, Fudan University, Shanghai, China 200032. Email:
[email protected] Fax: 0086-021-64041990
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This article was funded by the Foundation of Shanghai Health Bureau (20124351)
1
Hu
ACCEPTED MANUSCRIPT Abstract
Objectives A postoperative CSF leak was considered a major drawback of endonasal endoscopic skull base surgery, especially when high-flow intraoperative CSF leakage
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occurred. The combined use of a gasket seal closure and a vascularized pedicle nasoseptal flap (VP-NSF) multilayered reconstruction technique has recently emerged.
resulting from endonasal endoscopic skull base surgery.
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It is necessary to assess the efficacy of this new technique for high-flow CSF leaks
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Methods For patients with intraoperative high-flow CSF leaks, a VP-NSF multilayered reconstruction technique was used from Oct 2009 to June 2011 (single technique group), and a combination of a gasket seal closure and a VP-NSF multilayered reconstruction technique was used from Jul 2011 to Feb 2013 (combined
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technique group). A lumbar drain was placed after the operation. The rates of postoperative CSF leaks and repair-related complications between the two groups were analyzed.
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Results There were 18 patients in the single technique group. After a mean follow-up
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of 31.7 months, there were five postoperative CSF leaks (27.7%). There were 15 patients in the combined technique group. After a mean follow-up of 13.6 months, no CSF leaks occurred (P