Tension Pneumocephalus Following Orbital Exenteration

Shieh, Wen-Shi; Farrell, Christopher; Curry, Joseph M.; Murchison, Ann P.; Bilyk, Jurij R.

doi:10.1097/iop.0000000000000407

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…The overall complication rate in this series was 31.6%, in keeping with the literature for advanced and recurrent lesions of the skull base, which ranges from 30% to 40% . Major complications were experienced more commonly in SS cases ( P = 0.05).…”

Section: Discussionsupporting

confidence: 84%

Postoperative cerebrospinal fluid leak after microvascular reconstruction of craniofacial defects with orbital exenteration

et al. 2016

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Section: Discussionsupporting

confidence: 84%

Postoperative cerebrospinal fluid leak after microvascular reconstruction of craniofacial defects with orbital exenteration

et al. 2016

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“…On the other hand, Shieh reported a case of tension pneumocephalus after OE. This patient was treated with collagen, and engineered dural substitute fat graft, and temporalis muscle flap in order to close the dural tear in the orbital roof [32]. We did not have any cerebrospinal leak nor complicated sinoorbital fistula.…”

Section: Discussionmentioning

confidence: 99%

Lateral frontal galeal-cutaneous flap for reconstruction after orbital exenteration for advanced periorbital skin cancer

Kovačević¹,

Djordjević-Jocić²,

Radojković³

2021

Turk J Med Sci

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Background/aim: Orbital exenteration is one of the most disfiguring procedures leading to significant deformity. Defect reconstruction is challenging, especially in elderly patients. We have reviewed our experience of orbital exenteration and primary reconstruction with lateral frontal galeal-cutaneous flap based on superficial temporal artery. Materials and methods: Data on patients treated for non-melanoma skin cancer invading the orbit during the 10-year period were analyzed. Patients' demographics, tumor features, reconstructive technique used, complications and survival were recorded with a median follow-up of 27.5 months. Results: 26 patients in whom orbital exenteration was done were included in the study. There were 14 males and 12 females, mean aged 75.29 years (ranged 61-87). The majority of patients were treated for basal cell carcinoma with medial cantus as primary site. All defects were closed by lateral frontal galeal-cutaneous flap based on superficial temporal artery, and in two cases temporalis muscle pedicle flap was used as additional flap for reconstruction of orbital roof in order to separate the brain from empty orbit, and covered with same galeal-cutaneous flap. In 19 cases frontal area was closed primarily, and in 7 cases skin graft was used for secondary defect. There was no flap loss. Tumor related death was registered in three patients (inoperable recurrent tumors) (11.5%), 7 died as tumor unrelated (2 of them were operated from recurrent orbital tumor) and 16 survived. Conclusion: The preferred method for reconstruction after orbital exenteration in our university affiliated center is lateral frontal galeal-cutaneous flap based on superficial 2 temporal artery. The flap harvesting is simple, safe and obtains enough tissue for covering defects even after extended exenteration. Complication rate is low. We suggest the simultaneous use of this flap with pedicle temporalis muscle flap only for reconstruction of scull base after anterior cranial fossa resection.

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“…In our patient, the right dacryocystorhinostomy was done one day before the onset of symptoms. There had been a case report of tension pneumocephalus following orbital exenteration [ 8 ]. Due to the proximity of skull bones during ocular procedures, there remains a possibility of injuring the skull bone and ending up in pneumocephalus.…”

Section: Discussionmentioning

confidence: 99%

Tension Pneumocephalus After Right Dacryocystorhinostomy: A Rare but Potential Serious Complication

Sethi¹

2020

Cureus

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Tension pneumocephalus is a phenomenon in which air enters through dural injury in the brain and then expands and causes a mass effect. The injury can be due to any neurosurgical procedure, trauma, infection and/or neoplasm. A 63-year-old female known case of diabetes and hypertension had an elective procedure of right dacryocystorhinostomy present to the emergency department the very next day with a loss of consciousness. Urgent CT of the head showed air in the cranium (pneumocephalus). A radiological sign named “Mount Fuji” is classical for tension pneumocephalus. She was closely monitored and shows good clinical improvement allowing the neurosurgery team to avoid any intervention. The rationale to present this case is that to our knowledge, this is the first case in which tension pneumocephalus had occurred post-dacryocystorhinostomy. Due to the delicate region operated during eye surgeries, one should be more careful and vigilant.

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Tension Pneumocephalus Following Orbital Exenteration

Cited by 7 publications

References 20 publications

Postoperative cerebrospinal fluid leak after microvascular reconstruction of craniofacial defects with orbital exenteration

Postoperative cerebrospinal fluid leak after microvascular reconstruction of craniofacial defects with orbital exenteration

Lateral frontal galeal-cutaneous flap for reconstruction after orbital exenteration for advanced periorbital skin cancer

Tension Pneumocephalus After Right Dacryocystorhinostomy: A Rare but Potential Serious Complication

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