Endoscopic Endonasal Eustachian Tube Obliteration as a Treatment for Tension Pneumocephalus After Translabyrinthine Resection of Vestibular Schwannoma.
Otol Neurotol
; 43(8): e856-e860, 2022 09 01.
Article
in En
| MEDLINE
| ID: mdl-35970161
ABSTRACT
OBJECTIVE:
Cerebrospinal fluid leak and pneumocephalus are rare but potentially devastating complications associated with translabyrinthine resection of cerebellopontine angle masses. Persistent pneumocephalus despite proximal eustachian tube (ET) obliteration is rare. We describe, to our knowledge, the first report of successful management of tension pneumocephalus by endoscopic endonasal ET obliteration using a novel V-loc (Covidien; Medtronic, Minneapolis, MN) suture technique. PATIENTS A 63-year-old man presented with altered mental status 10 months after translabyrinthine excision of a left cerebellopontine angle vestibular schwannoma measuring 2.8 × 2.9 × 3.3 cm. Computed tomography demonstrated diffuse ventriculomegaly and new pneumocephalus along the right frontal lobe, lateral ventricles, and third ventricle, and air within the left translabyrinthine resection cavity. INTERVENTION The patient underwent left-sided endoscopic endonasal ET obliteration using 2-0, 9-inch V-loc suture. MAIN OUTCOMEMEASURE:
Postoperatively, the patient's mental status improved with a decrease in size of the lateral and third ventricles on computed tomography.CONCLUSION:
Endoscopic endonasal ET obliteration, a technique previously applied to recalcitrant cerebrospinal fluid leaks, is a safe and reasonable alternative to reentering the original surgical site for patients with pneumocephalus after lateral skull base surgery. Utilizing a V-loc suture for this technique instead of a traditional suture may improve procedural ease and speed.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pneumocephalus
/
Neuroma, Acoustic
/
Eustachian Tube
Type of study:
Etiology_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Otol Neurotol
Journal subject:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Year:
2022
Type:
Article