| Comparison of Postoperative Complication after Retrosigmoid Approach Microvascular Decompression for Hemifacial Sparsm : Craniectomy versus Osteoplastic Craniotomy |
|
Won Mo Gu, Won Il Joo, Hyoung Kyun Rha, Hae Kwan Park, Chung Kee Chough, Kyung Jin Lee |
|
Department of Neurosurgery, Yeouido St. Mary's Hospital Neuroscience Center, College of Medicine, The Catholic University of Korea, Seoul, Korea |
|
|
| Abstract |
Objective
The retrosigmoid approach provides an excellent access corridor to the cerebellopontine angle to perform microvascular decompression (MVD) of the facial nerve in patients with hemifacial spasm. We investigated our database for a comparative analysis of postoperative complications in craniectomy versus osteoplastic craniotomy after retrosigmoid approach for microvascular decompression.
Method: We were able to analyze the results of 72 patients that had undergone MVD for hemifacial spasm via suboccipital retrosigmoid approach. Among the 72 patients who underwent retrosigmoid surgery, 18 patients underwent craniectomy and 54 patients craniotomy. The follow up period ranged from 12 months to 3 years.
Result: At three days postoperative follow up, 9 (50.0%) out of 18 patient in the craniectomy group and 12 (22.2%) out of 54 patients in the osteoplastic craniotomy group suffered from postoperative headache (p=0.022). At 12 months postoperative follow up 3 (16.7%) patients in the craniectomy group but only 1 (1.9%) patients in the osteoplastic craniotomy group complained of headaches (p=0.043). Cerebrospinal fluid (CSF) leaks were 4 (22.2%) patients in craniectomy group and 2 (3.7%) patients in craniotomy group. CSF leak was statistically significantly lower in the group of patients who underwent craniotomy compared to craniectomy (p=0.028).
Conclusion
We observed a statistically significant reduced incidence of post-operative and follow-up headache in patients who underwent osteoplastic craniotomy compared to those undergoing retrosigmoid craniectomy. These results suggest that retrosigmoid cranioplasty is a good method to prevent postoperative headache and CSF leakage, in patients who undergo MVD. |
| Key Words:
Microvascular decompression surgery, Craniotomy, Postoperative, Headache, Cerebrospinal fluid leak. |
|
PDF Links
Full text via DOI
Download Citation
