Abstract
Objective: Descriptive study was aimed is to find out the frequency of CSF leak in retro mastoid surgery for Vestibular Schwannoma.
 Material and Methods: From 2017 to 2020, 63 patients underwent microsurgical excision of Vestibular Schwannoma with retro sigmoidal approach in the Department of Neurosurgery, Hayatabad Medical Complex, Peshawar. All patients of either sex underwent retro mastoid approach for Vestibular Schwannoma surgery, having complete dural closure per operatively were included in this study. Data was collected which included symptoms, clinical assessment, radiological findings, per-operative and postoperative findings. Patients were monitored for 30 days after surgery and checked for any CSF leaks.
 Results: There were 36 male and 27 female patients. In our study, the postoperative CSF leak was present in 9(14%) of cases. There was no significant difference (p-value 0.097) whether the dura was closed with graft and without graft. Insignificant differences existed in CSF leak vs. different age groups (p-value 0.964) and gender (p-value: 0.917).
 Conclusion: Our study found that after retro sigmoid approach for vestibular Schwannoma surgery, the frequency of CSF leak was 14%, which gives us insight into our complication rate and allows us to change our surgical procedure technique, such as using fibrin glue or less frequently artificial dura, to reduce this rate.
Highlights
Vestibular Schwannoma (VS) is the most common Cerebellopontine angle (CPA) tumor, which accounts for 80 – 95 percent of all CPA tumors.[1]
The postoperative Cerebrospinal Fluid (CSF) leak was present in 9(14%) of cases
Insignificant differences existed in CSF leak vs. different age groups (p-value 0.964) and gender (p-value: 0.917)
Summary
Vestibular Schwannoma (VS) is the most common Cerebellopontine angle (CPA) tumor, which accounts for 80 – 95 percent of all CPA tumors.[1] They are slow to grow and arise from the junction between oligodendrocytes and Schwann cells (Obersteiner Redlich Zone).[2] The inferior and superior vestibular nerves, peripheral parts, as well as the cochlear branch of the eighth cranial. Sohail Amir, et al: Frequency of Post-Operative Cerebrospinal Fluid (CSF) Leak in Retromastoid Surgery for Vestibular nerve, are the sites of origin of these tumors. These are uncommon, accounting for about 10% of primary intracranial tumors, 85% of Cerebellopontine angle tumors, and 90% of Schwannomas of the brain.[3,4]
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