Microvascular decompression: incidence and prevention of postoperative CSF leakage in a consecutive series of 134 patients

Br J Neurosurg. 2020 Aug;34(4):416-418. doi: 10.1080/02688697.2020.1749989. Epub 2020 May 2.

Abstract

Introduction: Microvascular decompression (MVD) is an established procedure for treating Trigeminal Neuralgia and Hemifacial Spasm. Postoperative CSF leakage is still a common complication after MVD.Material and Methods: We did a retrospective study of 134 patients who underwent microvascular decompression, mainly for Trigeminal Neuralgia and Hemifacial Spasm in our unit. All patients had an apparently watertight repair of the dura at the end of the operation done by our technique using Duraguard ® and Histacryl® glue.Results: Of the 134 patients, 129 (96.2%) had no postoperative CSF leakage. Only five (3.7%) of the patients experienced postoperative CSF leak.Conclusion: We conclude that dural repair using the described technique, with a dural substitute (Duraguard) and Histacryl glue is safe and effective in preventing postoperative CSF leakage following MVD.

Keywords: CSF leak; duraplasty; microvascular decompression.

MeSH terms

  • Cerebrospinal Fluid Leak / epidemiology
  • Cerebrospinal Fluid Leak / prevention & control
  • Hemifacial Spasm* / surgery
  • Humans
  • Incidence
  • Microvascular Decompression Surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Trigeminal Neuralgia / surgery