Complications in retrosigmoid cranial nerve surgery

Abstract

Of the cases with complications, two (0.4%) died. Hearing impairment ranging from mild to severe occurred in 31 (6.0%) patients; 4 of these (0.8%) presented total hearing loss. Postoperative cerebrospinal fluid leakage occurred in 29 (5.6%) cases.

Closed-Suction Drainage and Cerebrospinal Fluid Leakage Following Microvascular Decompression : A Retrospective Comparison Study

“…Many studies have examined CSF leakage following lateral skull base surgeries for neurovascular compression, vestibular schwannoma, etc1,7,15). However, these studies did not precisely define CSF leakage.…”

“…CSF leakage following MVD was defined as follows : 1) rhinorrhea, otorrhea, pseudomeningocele, and/or an incisional leak at any time following MVD irrespective of the development of central nervous system infections1); 2) middle ear effusions, generally accompanied by ear fullness, identified by thorough otological evaluations7); 3) CSF leakage developing on postoperative day 2 or later, considering the time required for drainage of the fluid that potentially flowed into the mastoid air cells before waxing of the inlet during the procedure; and 4) persistence of CSF leakage for 2 or more days; in cases of middle ear effusion, effusion was identified at the follow-up otological evaluation 2 or 3 days following the initial exam.…”

“…Closed-suction drainage has traditionally been used to prevent postoperative hematoma or in cases of uncertain hemostasis6). However, the quoted incidence of intracranial hematoma following MVD is only 0.4-0.5%5,7). Moreover, epidural hematoma at the surgical site, for which only closed-suction drainage can work, appears to be even rarer.…”

Regulatory and Funding Strategies to Develop a Safety Study of an Auditory Brainstem Implant in Young Children Who Are Deaf

“…For the ABI to be considered a feasible treatment going forward, the number of serious expected surgical events could not exceed the known rate of retrosigmoid craniotomy events. Retrosigmoid craniotomy carries with it the risk of cerebrospinal fluid leak [31–33], meningitis [34], hematoma [31], facial palsy [35], cerebellar edema and hydrocephalus [36]. Each of these risks, in and of themselves, has well-established treatment protocols and do not increase the benefit/risk tradeoff adversely.…”

Microvascular Decompression for Glossopharyngeal Neuralgia : Clinical Analyses of 30 Cases

“…Given its rarity, only a limited number of reports on the long-term results of MVD for GPN is available 7 , 15 , 19 , 26 , 28 , 40) . Considering the relatively low success rate (55%) following stereotactic radiosurgery, MVD should be considered a better alternative despite its possible drawbacks 16 , 22) .…”