A novel multilayered membrane repair technique for high-flow cerebrospinal fluid leaks during expanded endoscopic endonasal tumor resection.

Abstract

Background: Postoperative cerebrospinal fluid (CSF) leak is a life-threatening complication following endoscopic skull base surgery. This study describes a multilayered membrane reconstruction strategy for treating high-flow intraoperative CSF leaks during expanded endoscopic endonasal tumor resection (EEA) and presents the associated outcomes, supplemented by surgical video documentation.

Methods: A retrospective review was performed on patients who underwent multilayered membrane reconstruction for high-flow CSF leaks during EEA.

Results: From January 2019 to June 2023, 15 patients undergoing EEA experienced high-flow intraoperative CSF leaks and received multilayered membrane reconstruction. Tumor pathologies included pituitary adenoma, craniopharyngioma, and meningioma. After a median postoperative follow-up of 13 months, no postoperative CSF leakage, intracranial infection, meningitis, and pneumocephalus was detected.

Conclusion: Our preliminary experience indicates that the multilayered membrane reconstruction technique may be a reliable method for achieving a watertight closure of high-flow intraoperative CSF leaks during EEA and warrants further study.