The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus
Objectives: Information about the endonasal endoscopic approach (EEA) for the management of posttraumatic tension pneumocephalus (PTTP) remains scarce. Concomitant rhinoliquorrhea and posttraumatic hydrocephalus (PTH) can complicate the clinical course. Methods: The authors systematically reviewed p...
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my.um.eprints.422242023-10-15T06:49:58Z http://eprints.um.edu.my/42224/ The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus Dalolio, Martina Cordier, Dominik Al-Zahid, Saif Bennett, Warren O. Narayanan, Prepageran Mathaneswaran, Vickneswaran Mariani, Luigi Koeppl, Ruth Brand, Yves Roethlisberger, Michel RF Otorhinolaryngology Objectives: Information about the endonasal endoscopic approach (EEA) for the management of posttraumatic tension pneumocephalus (PTTP) remains scarce. Concomitant rhinoliquorrhea and posttraumatic hydrocephalus (PTH) can complicate the clinical course. Methods: The authors systematically reviewed pertinent articles published between 1961 and December 2020 and identified 6 patients with PTTP treated by EEA in 5 reports. Additionally, the authors share their institutional experience including a seventh patient, where an EEA resolved a recurrent PTTP without rhinoliquorrhea. Results: Seven PTTP cases in which EEA was used as part of the treatment regime were included in this review. All cases presented with a defect in the anterior skull base, and 3 of them had concomitant rhinoliquorrhea. A transcranial approach was performed in 6/7 cases before EEA was considered to treat PTTP. In 4/7 cases, the PTTP resolved after the first intent; in 2/ 7 cases a second repair was necessary because of recurrent PTTP, 1 with and 1 without rhinoliquorrhea, and 1/7 case because of recurrent rhinoliquorrhea only. Overall, PTTP treated by EEA resolved with a mean radiological resolution time of 69 days (range 23-150 days), with no late recurrences. Only 1 patient developed a cerebrospinal fluid diversion infection probably related to a first incomplete EEA skull base defects repair. A permanent cerebrospinal fluid diversion was necessary in 3/7 cases. Conclusions: Endonasal endoscopic approach repair of air conduits is a safe and efficacious second-line approach after failed transcranial approaches for symptomatic PTTP. However, the strength of recommendation for EEA remains low until further evidence is presented. Lippincott Williams & Wilkins 2022-05 Article PeerReviewed Dalolio, Martina and Cordier, Dominik and Al-Zahid, Saif and Bennett, Warren O. and Narayanan, Prepageran and Mathaneswaran, Vickneswaran and Mariani, Luigi and Koeppl, Ruth and Brand, Yves and Roethlisberger, Michel (2022) The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus. Journal Of Craniofacial Surgery, 33 (3). pp. 875-881. ISSN 1049-2275, DOI https://doi.org/10.1097/SCS.0000000000008204 <https://doi.org/10.1097/SCS.0000000000008204>. 10.1097/SCS.0000000000008204 |
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RF Otorhinolaryngology Dalolio, Martina Cordier, Dominik Al-Zahid, Saif Bennett, Warren O. Narayanan, Prepageran Mathaneswaran, Vickneswaran Mariani, Luigi Koeppl, Ruth Brand, Yves Roethlisberger, Michel The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
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Objectives: Information about the endonasal endoscopic approach (EEA) for the management of posttraumatic tension pneumocephalus (PTTP) remains scarce. Concomitant rhinoliquorrhea and posttraumatic hydrocephalus (PTH) can complicate the clinical course. Methods: The authors systematically reviewed pertinent articles published between 1961 and December 2020 and identified 6 patients with PTTP treated by EEA in 5 reports. Additionally, the authors share their institutional experience including a seventh patient, where an EEA resolved a recurrent PTTP without rhinoliquorrhea. Results: Seven PTTP cases in which EEA was used as part of the treatment regime were included in this review. All cases presented with a defect in the anterior skull base, and 3 of them had concomitant rhinoliquorrhea. A transcranial approach was performed in 6/7 cases before EEA was considered to treat PTTP. In 4/7 cases, the PTTP resolved after the first intent; in 2/ 7 cases a second repair was necessary because of recurrent PTTP, 1 with and 1 without rhinoliquorrhea, and 1/7 case because of recurrent rhinoliquorrhea only. Overall, PTTP treated by EEA resolved with a mean radiological resolution time of 69 days (range 23-150 days), with no late recurrences. Only 1 patient developed a cerebrospinal fluid diversion infection probably related to a first incomplete EEA skull base defects repair. A permanent cerebrospinal fluid diversion was necessary in 3/7 cases. Conclusions: Endonasal endoscopic approach repair of air conduits is a safe and efficacious second-line approach after failed transcranial approaches for symptomatic PTTP. However, the strength of recommendation for EEA remains low until further evidence is presented. |
format |
Article |
author |
Dalolio, Martina Cordier, Dominik Al-Zahid, Saif Bennett, Warren O. Narayanan, Prepageran Mathaneswaran, Vickneswaran Mariani, Luigi Koeppl, Ruth Brand, Yves Roethlisberger, Michel |
author_facet |
Dalolio, Martina Cordier, Dominik Al-Zahid, Saif Bennett, Warren O. Narayanan, Prepageran Mathaneswaran, Vickneswaran Mariani, Luigi Koeppl, Ruth Brand, Yves Roethlisberger, Michel |
author_sort |
Dalolio, Martina |
title |
The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
title_short |
The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
title_full |
The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
title_fullStr |
The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
title_full_unstemmed |
The role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
title_sort |
role of endonasal endoscopic skull base repair in posttraumatic tension pneumocephalus |
publisher |
Lippincott Williams & Wilkins |
publishDate |
2022 |
url |
http://eprints.um.edu.my/42224/ |
_version_ |
1781704612309368832 |
score |
13.154949 |