Under what circumstances do you utilize an EVD rather than a lumbar drain for management of CSF leak after a transphenoidal resection?

Rarely is there any indication for CSF diversion at all for CSF leaks after translabyrinthine craniotomy. The reason for this is that, by definition, patients have no hearing on the operated side. Blind sac closure of the external ear canal and direct packing of the Eustachian tube successfully trea...

Only if preop hydrocephalus or elevated ICP, or if EVD was inserted already, or if no access to the lumbar spine. Otherwise, almost never.