Comparison of postoperative headache after retrosigmoid approach: Vestibular nerve section versus vestibular schwannoma resection

2000 ◽  
Vol 21 (3) ◽  
pp. 412-416 ◽  
Author(s):  
C JACKSON ◽  
B MCGREW ◽  
J FOREST ◽  
C HAMPF ◽  
M GLASSCOCKIII ◽  
...  
2003 ◽  
Vol 128 (3) ◽  
pp. 387-395 ◽  
Author(s):  
Bernhard Schaller ◽  
Ariane Baumann

OBJECTIVE: Our goal was to study the occurrence and source of origin of postcraniotomy headache syndrome after removal of vestibular schwannoma via the retrosigmoid approach. METHODS: A retrospective chart analysis was conducted of all patients with headache at 3 months after removal of vestibular schwannoma from January 1981 through March 1997 and with a minimum of 24 months of follow-up. Diagnosis was made according to the headache classification and was graded using the HARNER scale. Recovery outcome was compared in selected groups of patients with and without headache. A descriptive statistical analysis was used to analyze differences between groups. RESULTS: Of the patients who underwent retrosigmoid craniotomy for removal of vestibular schwannomas, 52 of 155 patients (34%) reported having severe headache of requiring medication every day and/or feeling incapacitated 3 months after surgery. Headache was more prevalent in those who had the bone flap replaced (94% versus 27%), if there was duraplastic or direct dura closure (0% versus 100%). Laboratory-proven aseptic meningitis, most likely due to the use of fibrin glue and drilling of posterior aspect of the internal auditory canal, was mainly associated with postoperative headache (81% versus 2%). In 75% of these cases, calcifications along the brainstem had been noted. CONCLUSION: The origin of postoperative headaches after retrosigmoid vestibular schwannoma resections is not yet fully understood. Different factors may play a role in preventing or reducing headache: dural adhesions to nuchal muscles or to subcutaneous tissues and dural tension in the case of direct dural closure may explain postoperative headache from dural tension. Intradural drilling and the use of fibrin glue may be the source of aseptic meningitis as the etiology of persistent postoperative headache. Prevention of postoperative headache may include the replacement of bone flap at the end of surgery, duraplastic instead of direct dural closure, and prevention of the use of fibrin glue or extensive drilling of the posterior aspect of internal auditory canal.


Skull Base ◽  
2005 ◽  
Vol 15 (04) ◽  
pp. 292-292
Author(s):  
Nebil Goksu ◽  
Metin Yilmaz ◽  
Ismet Bayramoglu ◽  
Yildirim A Bayazit

Skull Base ◽  
2005 ◽  
Vol 15 (04) ◽  
pp. 292-292
Author(s):  
Nebil Goksu ◽  
Metin Yilmaz ◽  
Ismet Bayramoglu ◽  
Yildirim A Bayazit

2019 ◽  
pp. 105-133
Author(s):  
Pınar Eser Ocak ◽  
Ihsan Dogan ◽  
Sima Sayyahmelli ◽  
Mustafa K. Baskaya

2022 ◽  
Vol 157 ◽  
pp. 1
Author(s):  
Guilherme H.W. Ceccato ◽  
Júlia S. de Oliveira ◽  
Pedro H.S. Neto ◽  
Nick D. de Carvalho ◽  
Vinícius N. Coelho ◽  
...  

2015 ◽  
Vol 129 (12) ◽  
pp. 1182-1187 ◽  
Author(s):  
U Patnaik ◽  
A Srivastava ◽  
K Sikka ◽  
A Thakar

AbstractObjective:To present the profile of patients undergoing surgical treatment for vertigo at a contemporary institutional vertigo clinic.Study design:A retrospective analysis of clinical charts.Methods:The charts of 1060 patients, referred to an institutional vertigo clinic from January 2003 to December 2012, were studied. The clinical profile and long-term outcomes of patients who underwent surgery were analysed.Results:Of 1060 patients, 12 (1.13 per cent) were managed surgically. Of these, disease-modifying surgical procedures included perilymphatic fistula repair (n = 7) and microvascular decompression of the vestibular nerve (n = 1). Labyrinth destructive procedures included transmastoid labyrinthectomy (n = 2) and labyrinthectomy with vestibular nerve section (n = 1). One patient with vestibular schwannoma underwent both a disease-modifying and destructive procedure (translabyrinthine excision). All patients achieved excellent vertigo control, classified as per the American Academy of Otolaryngology – Head and Neck Surgery 1995 criteria.Conclusion:With the advent of intratympanic treatments, surgical treatments for vertigo have become further limited. However, surgery with directed intent, in select patients, can give excellent results.


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