Long Term Outcomes of Cerebrospinal Fluid Leak Management in Paediatric Posterior Fossa Surgery

Abstract

Objective: To evaluate the long-term outcomes of CSF leak management in paediatric posterior fossa surgeries and to identify the effectiveness of various management strategies and their relationship with surgery types.

Methodology: A retrospective study was conducted from January 2023 to December 2023, involving 150 paediatric patients who underwent posterior fossa surgeries. Data on patient demographics, surgery type, CSF leak management strategies, and postoperative outcomes were collected from medical records. Statistical analysis included descriptive statistics and chi-square tests.

Results: The mean age of the patients was 10.2 ± 5.1 years, with 51% males and 49% females. The most common management strategies were lumbar drainage (37%) and duraplasty (28%). Tumour resections more frequently required revision surgery (24%) compared to Chiari malformation decompressions. A significant statistical association (p = 0.0286) was observed between surgery type and CSF leak management strategy. Outcomes showed that lumbar drainage had a higher incidence of recurrence (15%) and pseudomeningoceles (5%) compared to duraplasty, which had a 90% success rate in resolving CSF leaks.

Conclusion: Lumbar drainage and duraplasty are effective methods for managing CSF leaks in paediatric posterior fossa surgeries. Tailored management strategies based on surgery type are crucial for improving outcomes. The study provides local insights into CSF leak management in Pakistan and highlights the need for further research, including prospective and multicentre studies.

Keywords: Cerebrospinal fluid leak, Cranial fossa, Foass postrea CSF leak, Posterior fossa, Paediatric posterior, Paediatric,