Less than 1% cerebrospinal fluid leakage in 1,803 translabyrinthine vestibular schwannoma surgery cases.

OBJECTIVE: To determine the incidence rate of cerebrospinal fluid (CSF) leak after translabyrinthine vestibular schwannoma surgery since the alteration of the surgical procedure. To compare with previous series and other series in literature. STUDY DESIGN: Database analysis. SETTING: Tertiary referral neurotologic private practice. PATIENTS: A series of 1,803 patients who underwent translabyrinthine vestibular schwannoma surgery between 1993 and 2009. The result of this group was compared with corresponding series. INTERVENTION: Translabyrinthine and extended translabyrinthine vestibular schwannoma surgery. Literature review and comparison. MAIN OUTCOME MEASURES: Rates of CSF leak in this series and historical perspective of the outcome. RESULTS: Fifteen patients (0.8%) of 1,803 cases had CSF leaks. The method used since 1993 has shown a significant improvement compared with major case series of the last 10 years. CONCLUSION: The methods used in translabyrinthine vestibular schwannoma surgery in our center can reduce CSF leakage to an absolute minimum. Compared with all large series, this could be a new era of translabyrinthine vestibular schwannoma surgery.