Radial forearm free tissue transfer in the management of persistent cerebrospinal fluid leaks

Stephen M. Weber, Jason Kim, Johnny B. Delashaw, Mark Wax

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: Cerebrospinal fluid (CSF) leaks can occur after head trauma or skull base surgery. Persistent or spontaneous leaks should be repaired, since they put patients at risk for serious intracranial complications. Although numerous repair methods have been successful, the occasional patient develops a persistent leak. We describe our experience with free tissue transfer for repair of recalcitrant CSF leaks. Study Design: Retrospective chart review of patients undergoing free tissue transfer for repair of a CSF leak between November 1995 and October 2004. Setting was an academic, tertiary care referral center. Methods: Twelve patients with persistent CSF leak were studied. Eleven of 12 patients had undergone a previous repair attempt ranging from endoscopic repair with fat graft to craniotomy and primary repair of the dural defect. All patients underwent radial forearm free tissue transfer. Results: There were six female and six male patients. Average age was 52.7 years (range, 22-80 y). The most common presenting complaints were intracranial abscess, recurrent meningitis, or pneumocephalus (n = 9) and CSF otorrhea or rhinorrhea (n = 8). Cause was head trauma (n = 6), prior surgery (n = 4), cholesteatoma (n = 1), or meningoencephalocele (n = 1). Eleven of 12 patients failed prior procedures (range, 0-6 procedures; mean, 1.9). Ten flaps were placed in the anterior skull base and two were in the middle or posterior skull base. Radial forearm free tissue transfer resulted in sustained resolution of CSF leakage in all 12 patients. Conclusions: Free tissue transfer is an efficacious option in the repair of recalcitrant CSF leaks.

Original languageEnglish (US)
Pages (from-to)968-972
Number of pages5
JournalLaryngoscope
Volume115
Issue number6
DOIs
StatePublished - Jun 2005

Fingerprint

Forearm
Skull Base
Craniocerebral Trauma
Tertiary Care Centers
Cerebrospinal Fluid Otorrhea
Cerebrospinal Fluid Rhinorrhea
Pneumocephalus
Cerebrospinal Fluid Leak
Cholesteatoma
Craniotomy
Meningitis
Abscess
Retrospective Studies
Fats
Transplants

Keywords

  • CSF leak
  • Free tissue transfer
  • Skull base reconstruction

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Radial forearm free tissue transfer in the management of persistent cerebrospinal fluid leaks. / Weber, Stephen M.; Kim, Jason; Delashaw, Johnny B.; Wax, Mark.

In: Laryngoscope, Vol. 115, No. 6, 06.2005, p. 968-972.

Research output: Contribution to journalArticle

Weber, Stephen M. ; Kim, Jason ; Delashaw, Johnny B. ; Wax, Mark. / Radial forearm free tissue transfer in the management of persistent cerebrospinal fluid leaks. In: Laryngoscope. 2005 ; Vol. 115, No. 6. pp. 968-972.
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