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J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e271-e274
DOI: 10.1055/s-0033-1349337
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Endonasal Endoscopic Release of a Delayed Tension Pneumocephalus After Craniofacial Resection of a Tumor of the Anterior Skull Base

Boris Krischek
1   Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
2   Department of Neurosurgery, University of Tübingen, Tübingen, Germany
,
Allan Vescan
3   Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
,
Christian Zweifel
1   Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
,
Gelareh Zadeh
1   Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
,
Fred Gentili
1   Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
› Author Affiliations
Further Information

Publication History

18 September 2012

02 April 2013

Publication Date:
24 October 2013 (online)

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Abstract

Tension pneumocephalus is a rare complication that can occur after craniofacial resection of lesions of the anterior skull base. Early diagnosis is important to avoid potential serious neurologic deficits, including death. It has been associated with the perioperative placement of a lumbar drainage and with esthesioneuroblastoma. Therapy consists of evacuation of the intracranial air as well as conservative measures. Here we report a case of a patient with an ethmoidal esthesioneuroblastoma who underwent a traditional microsurgical craniofacial resection and developed a delayed epidural tension pneumocephalus. This was treated by performing an incision in the pericranial flap covering the anterior cranial base defect using an endonasal endoscopic approach. To our knowledge, this particular treatment technique has not been reported before in this context.

Keywords

tension pneumocephalus - endonasal endoscopic approach - craniofacial resection - pericranial flap
 

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