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Shahid Khan

James Cook University Hospital, UK

Title: Microvascular Decompression: Incidence and Prevention of Post-operative CSF Leakage in a Consecutive Series of 134 Patients

Biography

Biography: Shahid Khan

Abstract

Objective: The aim of this study is to share our experience of an effective dural repair technique, which we have utilised to minimise the incidence of postoperative CSF leakage in patients undergoing microvascular decompression (MVD) for Trigeminal Neuralgia and Hemifacial Spasm.

Methods:  Between 1987 and 2018, 134 patients had microvascular decompression, mainly for Trigeminal Neuralgia and Hemifacial Spasm  in our unit. All our patients having posterior fossa MVD using the technique described by Janetta, had an apparently watertight repair of the dura at the end of the operation.   We describe our technique using Duraguard ® and Histacryl® glue. The post-operative outcome of the duraplasty was assessed retrospectively by case note review. 

Results:   Of 134 patients, 129 (96.2%) had no post-operative CSF leakage. Only 5 (3.7%) of the patients experienced  post-operative CSF  leakage.(3 from the wound,  2 from the nose)

Conclusion: We conclude that dural repair using the described technique  utilising  a dural substitute (Duraguard) and Histacryl glue  is safe and effective in preventing post operative CSF leak following MVD.

Keyword: CSF leak, Duraplasty, Microvascular Decompression(MVD).