Posterior Fossa Surgery
Conditions
Brief summary
Posterior fossa surgery represents on of the most demanding procedure in neurosurgery. Retrosygmoid (RS), key-hole retrosygmoid (KR) and cerebellar hemispheric (CH) are the most common approaches used to access in this area. Despite they are not technically difficult to perform, these approaches can be burdened by postoperative cerebrospinal fluid (CSF) leakage, both at short and long-term follow-up, with an high risk of meningitis. Many techniques were employed to avoid this risk, but it can still be estimated between 2% and 11% according to literature1-4. Spena et al. reported a CSF leakage rate of 6.8% in a previous experience5. As a consequence, newer efforts are necessaries to avoid this potentially lethal complication. By this explorative study, we want to retrospectively analyzed our experience with a newer technique of bone closure, called O'Ring, in patients subdued to posterior fossa surgery by RS, KR and CH approaches, focusing on postoperative CSF leakage (primary objective), wound complications and subcutaneous CSF collections (secondary objectives).
Interventions
PROCEDUREO-ring technique
O-ring technique. consists on a different arrangement of fibrin-glue on a polymethilmetacrylate cranioplasty, with the aim to create a gasket to prevent CSF leakage
Sponsors
Fondazione IRCCS Policlinico San Matteo di Pavia
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age ≥18 years, * availability of pre- and postoperative radiological and clinical data, * a follow-up period of at least 3 months.
Exclusion criteria
* Lacking of clinical, radiological and surgical data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| to estimate incidence of postoperative CSF leakage | 7 days | cumulative incidence of postoperative CSF leakage |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| to estimate incidence CSF leakage at 1- and 3-months of follow-up. | 1 and 3 months | cumulative incidence of CSF leakage at 1- and 3-months follow-up |
| to estimate the incidence of wound complications postoperatively and at 1- and 3-months | 1 and 3 months | cumulative incidence of wound complications postoperatively and at 1- and 3-months follow-up |
| to estimate the incidence of subcutaneous CSF collections postoperatively and at 1 and 3-months radiological follow-up | 1 and 3 months | cumulative incidence of subcutaneous CSF collections postoperatively and at 1 and 3-months radiological follow-up |
Countries
Italy
Outcome results
None listed