Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Closed-Suction Drainage and Cerebrospinal Fluid Leakage Following Microvascular Decompression : A Retrospective Comparison Study

  • Kim, Young-Hoon (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Han, Jung Ho (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Chae-Yong (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Oh, Chang Wan (Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • Received : 2012.11.23
  • Accepted : 2013.08.05
  • Published : 2013.08.28
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Abstract

Objective : We performed this study to investigate whether the use of closed-suction drainage following microvascular decompression (MVD) causes cerebrospinal fluid (CSF) leakage. Methods : Between 2004 and 2011, a total of 157 patients with neurovascular compression were treated with MVD. MVD was performed for hemifacial spasm in 150 (95.5%) cases and for trigeminal neuralgia in 7 (4.5%) cases. The mean age of the patients was $49.8{\pm}9.6$ years (range, 20-69). Dural substitutes were used in 44 (28.0%) patients. Ninety-two patients (58.6%) were underwent a 4-5 cm craniotomy using drainage (drainage group), and 65 (41.4%) did a small 2-2.5 cm retromastoid craniectomy without closed-suction drainage (no-drainage group). Results : Eleven (7.0%) patients experienced CSF leakage following MVD based on the criteria of this study; all of these patients were in the drainage group. In the unadjusted analyses, the incidence of CSF leakage was significantly related with the use of closed-suction drainage following MVD (12.0% in the drainage group vs. 0% in the no-drainage group, respectively; p=0.003; Fisher's exact test). Those who received dural substitutes and the elderly (cut-off value=60 years) exhibited a tendency to develop CSF leakage (p=0.075 and p=0.090, respectively; Fisher's exact test). In the multivariate analysis, only the use of closed-suction drainage was significantly and independently associated with the development of CSF leakage following MVD (odds ratio=9.900; 95% confidence interval, 1.418 to infinity; p=0.017). Conclusion : The use of closed-suction drainage following MVD appears to be related to the development of CSF leakage.

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