Cerebrospinal fluid diverters for cranial base repair in endoscopic endonasal approaches

Abstract

Introduction: Endoscopic endonasal approaches offer multiple advantages for the surgical management of cranial base tumors. However, postoperative cerebrospinal fluid fistula is high. Cerebrospinal fluid diverters are used as preventive or therapeutic methods to reduce this complication. Objectives: Describe the results of using cerebrospinal fluid diversion methods in cranial base repair. Method: A descriptive, prospective study was carried out on 77 patients with cranial base tumors operated on by endoscopic endonasal approaches, in which cerebrospinal fluid diversion methods were used. A postoperative evaluation of their use was carried out, evaluating complications and effectiveness in relation to cerebrospinal fluid leak. For data analysis, absolute and relative frequencies were used as summary measures. Results: There was a predominance of the use of lumbar spinal drainage over ventriculoperitoneal shunt (83.1% /16.9%). Complications experienced with lumbar spinal drains were: Post-puncture headache (6.5%), cerebrospinal fluid fistula (2.6%), central nervous system infection (1.3%). While, with the use of ventriculoperitoneal shunt, pneumocephalus was only evident in one patient (1.3%). 97.4 % of the methods were determined to be effective. Conclusions: With the present study, the favorable results of the use of cerebrospinal fluid diversion methods in the repair of the cranial base in endoscopic endonasal approaches are evident.

Keywords

• base del cráneo
• derivaciones del líquido cefalorraquídeo
• derivación ventriculoperitoneal
• neuroendoscopía
• punción espinal.