Tension Pneumocephalus from Positive Pressure Ventilation Following Endoscopic Skull Base Surgery: Case Series and an Institutional Protocol for the Management of Postoperative Respiratory Distress.
Aged
Cerebrospinal Fluid Leak
/ etiology
Female
Humans
Male
Middle Aged
Neurosurgical Procedures
/ adverse effects
Pituitary Neoplasms
/ diagnosis
Pneumocephalus
/ diagnosis
Postoperative Complications
/ diagnosis
Plastic Surgery Procedures
/ methods
Respiratory Distress Syndrome
/ diagnosis
Skull Base
/ surgery
Surgical Flaps
/ surgery
Endoscopic
Nasoseptal flap
Pituitary
Resuscitation
Tension pneumocephalus
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
01
05
2020
revised:
08
06
2020
accepted:
09
06
2020
pubmed:
21
6
2020
medline:
8
1
2021
entrez:
21
6
2020
Statut:
ppublish
Résumé
Tension pneumocephalus (TP) is a rare but feared complication of endoscopic endonasal skull base surgery. In contrast to simple pneumocephalus, which is common after endoscopic transnasal approaches and managed conservatively, TP represents a neurosurgical emergency and mandates urgent decompression. Here we present 2 cases of TP as a consequence of positive pressure ventilation following endoscopic endonasal skull base surgery. Both occurred during resuscitation for postoperative hypoxia. These cases prompted the development of an institution-wide protocol to identify and manage patients at risk of TP after extended skull base approaches. To our knowledge, these are the only such cases of postoperative TP following positive pressure ventilation in the literature.
Sections du résumé
BACKGROUND
Tension pneumocephalus (TP) is a rare but feared complication of endoscopic endonasal skull base surgery. In contrast to simple pneumocephalus, which is common after endoscopic transnasal approaches and managed conservatively, TP represents a neurosurgical emergency and mandates urgent decompression.
CASE DESCRIPTION
Here we present 2 cases of TP as a consequence of positive pressure ventilation following endoscopic endonasal skull base surgery. Both occurred during resuscitation for postoperative hypoxia. These cases prompted the development of an institution-wide protocol to identify and manage patients at risk of TP after extended skull base approaches.
CONCLUSIONS
To our knowledge, these are the only such cases of postoperative TP following positive pressure ventilation in the literature.
Identifiants
pubmed: 32562901
pii: S1878-8750(20)31337-1
doi: 10.1016/j.wneu.2020.06.079
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
357-362Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.