Tension Pneumocyst after Transsphenoidal Surgery for Rathke’s Cleft Cyst: Case Report

Abstract

Suprasellar tension pneumocyst is an extremely rare complication of transsphenoidal surgery. To avoid this complication, the sellar floor should be repaired in a watertight fashion, and patients should be instructed to avoid blowing the nose, sneezing, straining, and coughing postoperatively.

Delayed Tension Pneumocephalus due to Rupture of the Pneumocyst

“…It has been also occurred after the paranasal sinus operation, decompression of subdural hematoma, posterior fossa operation in the sitting position and the transsphenoidal surgery. 3,4,7) Usually, tension pneumocephalus developed on the acute stage but there are a few of anecdotal reports of delayed occurrence. Some rarer causes and related conditions of pneumocephalus including tension pneumocephalus were reported: congenital defect of tegmen tympani, hyperpneumatization of cranium, VP shunt surgery, intravenous catheterization and rupture of an acquired nontraumatic middle fossa encephalocele.…”

“…The treatments consist of the administration of high inspired concentrations of oxygen in case of nitrous oxide anesthesia, conservative treatment, needle aspiration, burr hole trephination with continuous external drainage, or craniotomy with defect repair. 1,3) Recently endoscopic treatment has been used. 3,4,6) The neurosurgeon have to remind themselves the possibility of delayed pneumocyst formation and tension pneumocephalus in patients who experienced basal skull fracture quite a long time ago.…”

“…1,3) Recently endoscopic treatment has been used. 3,4,6) The neurosurgeon have to remind themselves the possibility of delayed pneumocyst formation and tension pneumocephalus in patients who experienced basal skull fracture quite a long time ago. A B…”

“…Some cases were reported after neurosurgical manipulation. 3,4,6,8,9) We describe a case of delayed tension pneumocephalus that presumably developed from rupture of the incompletely treated pneumocyst of the right anterior cranial fossa.…”

Endoscopic Decompression of Tension Pneumosella Following Transsphenoidal Pituitary Tumor Resection

“…Only a few reports have described expanding air confined to the sellar region after transsphenoidal surgery [7][8][9]. We report a rare case of tension pneumosella causing acute visual changes with recovery following endoscopic surgical decompression.…”