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Technical Modifications of Suboccipital Craniectomy for Prevention of Postoperative Headache

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Technical Modifications of Suboccipital Craniectomy for Prevention of Postoperative Headache
Id. 18114623
Idioma inglés
Titulo Technical Modifications of Suboccipital Craniectomy for Prevention of Postoperative Headache
Autor(es) Silverman, Damon A.
Hughes, Gordon B.
Kinney, Sam E.
Lee, Joung H.
Localización http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1151675
Versión 1.0
Estado Final
Descripción A retrospective review of 53 consecutive patients who underwent a retrosigmoid vestibular nerve section (VNS) or microvascular decompression (MVD) through a modified suboccipital craniectomy with a minimum follow-up of 2 years was performed. Technical modifications to the suboccipital craniectomy included a skin incision designed to avoid the lesser and greater occipital nerves; a small, 2-cm diameter craniectomy with no intradural drilling of bone; and a simplified closure to prevent muscle adhesion to dura without the need for cranioplasty. The presence, duration, and severity of postoperative headache were the primary outcome measures. Craniectomy-related complications, operative time, and length of hospital stay were also reviewed. The incidence of postoperative headache after suboccipital craniectomy was 7.5% at 3 months (4/53), 3.8% at 1 year (2/53), and 3.8% at 2 years (2/53). Complications related to craniectomy included cerebrospinal fluid leakage (5.7%), aseptic meningitis (1.9%), and superficial wound infection (1.9%). The mean operative time was 145 and 98 minutes for VNS and MVD, respectively. The mean hospital stay was 2.2 and 3.6 days for VNS and MVD, respectively. Technical modifications of suboccipital craniectomy during retrosigmoid VNS and MVD lowered the incidence of postoperative headache and craniectomy-related complications and had no adverse effect on operative time or length of hospital stay.
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Copyright
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
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Fecha de contribución 04-mar-2008
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