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Case Reports
. 2014 Dec;151(6):1081-3.
doi: 10.1177/0194599814547502. Epub 2014 Aug 19.

Tension pneumocephalus after endoscopic sinus surgery: a technical report of multiportal endoscopic skull base repair

Randall A Bly  1 , Ryan P Morton  2 , Louis J Kim  2 , Kristen S Moe  3
Affiliations
Case Reports

Tension pneumocephalus after endoscopic sinus surgery: a technical report of multiportal endoscopic skull base repair

Randall A Bly et al. Otolaryngol Head Neck Surg. 2014 Dec.
No abstract available

Keywords: CSF leak; endoscopy; multiportal; neuroendoscopy; tension pneumocephalus; transorbital.

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Conflict of interest statement

Disclosures

Competing interests: Louis J. Kim is a stockholder with SPI Surgical and a consultant for Aesculap and Microvention. Kris S. Moe is the founder and shareholder for SPI Surgical.

Sponsorships: None.

Funding source: NIH T32 DC00018 training grant from 2011 to 2012 (R.A.B.); 2013 resident research grant from the American Academy of Otolaryngology—Head and Neck Surgery Foundation (R.A.B.); University of Washington Housestaff Association resident research grant in 2012 (R.A.B.).

Figures

Figure 1
Figure 1
(A) Superior lid crease (blepharoplasty) incision. (B) Initial transnasal endoscopy and cerebrospinal fluid leak (arrows). (C) Stretched bridging veins demonstrated on sagittal head CT (arrows). (D) Intracranial transorbital endoscopy with subdural veins (arrows). (E) Transnasal instrument (*) through skull base defect; “F” indicates falx cerebri. (F) AlloDerm reconstruction (*).
Figure 2
Figure 2
(A) Skull base approach for repair of bilateral ethmoid roof defects through transnasal and transorbital endoscopic portals (arrows). (B) Schematic and coronal section (C) of the “brain sling” technique. Intradural reconstruction was performed with a large single piece of Alloderm with a Falx cutout (2B,C, green) bolstered with Duragen via the transorbital ports. Additional Alloderm was placed extradurally via the trasnasal port (2C, blue) to enhance the repair. (Reprinted with permission, University of Washington Creative Services ©2014. All rights reserved.)
See this image and copyright information in PMC

References

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    1. Wise SK, Harvey RJ, Patel SJ, Frankel BM, Schlosser RJ. Endoscopic repair of skull base defects presenting with pneumocephalus. J Otolaryngol Head Neck Surg. 2009;38:509–516. - PubMed
    1. Church CA, Chiu AG, Vaughan WC. Endoscopic repair of large skull base defects after powered sinus surgery. Otolaryngol Head Neck Surg. 2003;129:204–209. - PubMed

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