Posterior fossa cerrahisinde kraniyoplasti yapılan ve yapılmayan 62 hastada BOS fistülü, postoperatif baş ağrısı, serebellar pitozis gelişimi ve tedavisi
Yıl 2023,
Cilt: 13 Sayı: 1, 141 - 149, 16.03.2023
Can Yaldız
,
Okan Türk
,
Burak Tahmazoğlu
,
Ömer Faruk Şahin
,
Özgür Baran
,
Adil Can Karaoğlu
,
Mehmet Akif Ambarcıoğlu
,
Mustafa Kaya
,
Davut Ceylan
Öz
Amaç: Posterior fossa cerrahi yaklaşımları nöro-glial tümörler, vestibüler Schwannomlar, inklüzyon tümörleri, meningiomlar gibi çeşitli tümörlere ve vasküler lezyonlara ulaşmak için kullanılmaktadır
Yöntem ve Gereçler: 2014-2018 yılları arasında Nöroşirürji Kliniği'nde infratentoryal intrakranial kitle lezyonu nedeniyle opere edilen toplam 62 hasta çalışmaya dahil edildi.
Bulgular: Çalışma 2014-2018 yılları arasında %61,3 (n=38) erkek ve %38,72 (n=24) kadın olmak üzere 62 hasta ile gerçekleştirildi. Hastaların %33,9'una (n=21) kraniyoplasti yapılırken, 66,1 % (n=41) kranyoplasti geçirmedi.
Sonuç: Bizim bu çalışmamız, kranioplastinin baş ağrısı ve serebellar ektopi için yararlı olduğunu ancak BOS fistül gelişimini önlemede yetersiz olduğunu düşündürmektedir
Kaynakça
- 1. Aslantürk Y, Yılmaz N, Ökten AI, Akbay FY, Basmacı M, Taşkın Y. Posterior Fossa Tümörlerinde Cerrahi Tedavi Sonuçları. Van Tıp Dergisi. 2006; 13 (1):4-8. https://vantipderg.org/jvi.aspx?pdir=vtd&plng=tur&un=VTD-71091
- 2. Ling PY, Zachary S, Rohit K, Jyung RW, Liu JK. Reconstruction after retrosigmoid approaches using autologous fat graft-assisted Medpor Titan cranioplasty: assessmentof postoperative cerebrospinal fluid leaks and headachesin 60 cases. Acta Neurochir. 2014; 156:1879–1888. DOI: 10.1007/s00701-014-2190-x
- 3. Castaño-Leon AM, Cepeda S, Paredes I. Symptomatic ptosis cerebelli after suboccipital craniectomy in a patient with severe brain trauma. Brain injury. 2017;31(10):1294-1297. DOI: 10.1080/02699052.2017.1309571
- 4. Holly LT, Batzdorf U. Management of cerebellar ptosis following craniovertebral decompression for Chiari I malformation. J Neurosurg. 2001; 94:21–6. DOI: 10.3171/jns.2001.94.1.0021
- 5. Heller JB, Lazareff J, Gabbay JS, Lam S, Kawamoto HK, Bradley JP. Posterior cranial fossa box expansion leads to resolution of symptomatic cerebellar ptosis following Chiari I malformation repair. J Craniofac Surg. 2007;18:274–80. DOI: 10.1097/scs.0b013e31802c05ab
- 6. Udani V, Holly LT, Chow D, Batzdorf . Posterior fossa recon- struction using titanium plate for the treatment of cerebellar ptosis after decompression for Chiari malformation. World Neurosurg. 2014; 81:836–41. DOI: 10.1016/j.wneu.2013.01.081
- 7. Catalano PJ, Jacobowitz O, Post KD. Prevention of headache after retrosigmoid removal of acoustic tumors. Am J Otol. 1996; 17:904–908. https://pubmed.ncbi.nlm.nih.gov/8915420
- 8. Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V. Clinical outcome in cranioplasty: critical review in long-term follow-up. J Cranio fac Surg. 2003; 14:144–153. DOI: 10.1097/00001665-200303000-00003
- 9. Aydin S, Kucukyuruk B, Abuzayed B, Aydin S, Sanus GZ. Cranioplasty. Review of materials and techniques. J Neurosci Rural Pract. 2011; 2:162–167. doi: 10.4103/0976-3147.83584
- 10. Elhammady MS, Telischi FF, Morcos JJ. Retrosigmoidap- proach: indications, techniques, and results. Otolaryngol Clin North Am. 2012; 45:375–397. DOI: 10.1016/j.otc.2012.02.001
- 11. Charalampakis S, Koutsimpelas D, Gouveris H, Mann W. Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management. Eur Arch Oto-Rhino-L. 2011, 268:653–660. DOI: 10.1007/s00405-010-1480-z
- 12. Wazen JJ, Sisti M, Lam SM. Cranioplasty in acoustic neuroma surgery. Laryngoscope. 2000; 110:1294–1297. DOI: 10.1097/00005537-200008000-00013
- 13. Schaller B, Baumann A. Headache after removal of vestibular schwannoma via the retrosigmoid approach: a long-term follow-up- study. Otolaryng Head Neck Surg. 2003; 128:387–395. DOI: 10.1067/mhn.2003.104
- 14. Soumekh B, Levine SC, Haines SJ, Wulf JA. Retrospective study of postcraniotomy headaches in suboccipital approach: diag- nosis and management. Am J Otol. 1996; 17:617–619. https://pubmed.ncbi.nlm.nih.gov/8841709/
- 15. Williams B. A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain. 1978; 101:223–50. DOI: 10.1093/brain/101.2.223
- 16. Duddy MJ, Williams B. Hindbrain migration after decompression for hindbrain hernia: a quantitative assessment using MRI. Br J Neurosurg. 1991; 5:141–52. DOI: 10.3109/02688699108998460
- 17. Sahuquillo J, Rubio E, Poca MA, Rovira A, Rodriguez-Baeza A, Cervera C. Posterior fossa reconstruction: a surgical tech- nique for the treatment of Chiari I malformation and Chiari I/ syringomyelia complex – preliminary results and magnetic resonance imaging quantitative assessment of hindbrain migration. Neurosurgery. 1994; 35:874–884. DOI: 10.1227/00006123-199411000-00011
- 18. Batzdorf U, McArthur DL, Bentson JR. Surgical treatment of Chiari malformation with and without syringomyelia: experi- ence with 177 adult patients. J Neurosurg. 2013; 118:232–242. DOI: 10.3171/2012.10.JNS12305
Development and treatment of CSF fistula, post-operative headache, cerebellar ptosis in 62 patients who underwent posterior fossa cranioplasty or not following posterior fossa surgery
Yıl 2023,
Cilt: 13 Sayı: 1, 141 - 149, 16.03.2023
Can Yaldız
,
Okan Türk
,
Burak Tahmazoğlu
,
Ömer Faruk Şahin
,
Özgür Baran
,
Adil Can Karaoğlu
,
Mehmet Akif Ambarcıoğlu
,
Mustafa Kaya
,
Davut Ceylan
Öz
Objective: The approaches in posterior fossa surgery are used for accessing various tumors and vascular lesions including neuro-glial tumors, vestibular Schwannomas, inclusion tumors, meningiomas.
Materials and Methods: A total of 62 patients who underwent operation due to infra-tentorial intra-cranial mass lesion in Neuro-Surgery Clinic between 2014 and 2018 were included in the study.
Result: The study was conducted with 62 patients of whom 61.3% (n=38) were males and 38.72% (n=24) were females between 2014 and 2018. While 33.9% (n=21) of the patients underwent cranioplasty, 66.1% (n=41) did not undergo cranioplasty.
Conclusion: The preliminary study suggests that cranioplasty is useful for headache and cerebellar ectopy however insufficient for prevention of CNF fistula development.
Kaynakça
- 1. Aslantürk Y, Yılmaz N, Ökten AI, Akbay FY, Basmacı M, Taşkın Y. Posterior Fossa Tümörlerinde Cerrahi Tedavi Sonuçları. Van Tıp Dergisi. 2006; 13 (1):4-8. https://vantipderg.org/jvi.aspx?pdir=vtd&plng=tur&un=VTD-71091
- 2. Ling PY, Zachary S, Rohit K, Jyung RW, Liu JK. Reconstruction after retrosigmoid approaches using autologous fat graft-assisted Medpor Titan cranioplasty: assessmentof postoperative cerebrospinal fluid leaks and headachesin 60 cases. Acta Neurochir. 2014; 156:1879–1888. DOI: 10.1007/s00701-014-2190-x
- 3. Castaño-Leon AM, Cepeda S, Paredes I. Symptomatic ptosis cerebelli after suboccipital craniectomy in a patient with severe brain trauma. Brain injury. 2017;31(10):1294-1297. DOI: 10.1080/02699052.2017.1309571
- 4. Holly LT, Batzdorf U. Management of cerebellar ptosis following craniovertebral decompression for Chiari I malformation. J Neurosurg. 2001; 94:21–6. DOI: 10.3171/jns.2001.94.1.0021
- 5. Heller JB, Lazareff J, Gabbay JS, Lam S, Kawamoto HK, Bradley JP. Posterior cranial fossa box expansion leads to resolution of symptomatic cerebellar ptosis following Chiari I malformation repair. J Craniofac Surg. 2007;18:274–80. DOI: 10.1097/scs.0b013e31802c05ab
- 6. Udani V, Holly LT, Chow D, Batzdorf . Posterior fossa recon- struction using titanium plate for the treatment of cerebellar ptosis after decompression for Chiari malformation. World Neurosurg. 2014; 81:836–41. DOI: 10.1016/j.wneu.2013.01.081
- 7. Catalano PJ, Jacobowitz O, Post KD. Prevention of headache after retrosigmoid removal of acoustic tumors. Am J Otol. 1996; 17:904–908. https://pubmed.ncbi.nlm.nih.gov/8915420
- 8. Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V. Clinical outcome in cranioplasty: critical review in long-term follow-up. J Cranio fac Surg. 2003; 14:144–153. DOI: 10.1097/00001665-200303000-00003
- 9. Aydin S, Kucukyuruk B, Abuzayed B, Aydin S, Sanus GZ. Cranioplasty. Review of materials and techniques. J Neurosci Rural Pract. 2011; 2:162–167. doi: 10.4103/0976-3147.83584
- 10. Elhammady MS, Telischi FF, Morcos JJ. Retrosigmoidap- proach: indications, techniques, and results. Otolaryngol Clin North Am. 2012; 45:375–397. DOI: 10.1016/j.otc.2012.02.001
- 11. Charalampakis S, Koutsimpelas D, Gouveris H, Mann W. Post-operative complications after removal of sporadic vestibular schwannoma via retrosigmoid-suboccipital approach: current diagnosis and management. Eur Arch Oto-Rhino-L. 2011, 268:653–660. DOI: 10.1007/s00405-010-1480-z
- 12. Wazen JJ, Sisti M, Lam SM. Cranioplasty in acoustic neuroma surgery. Laryngoscope. 2000; 110:1294–1297. DOI: 10.1097/00005537-200008000-00013
- 13. Schaller B, Baumann A. Headache after removal of vestibular schwannoma via the retrosigmoid approach: a long-term follow-up- study. Otolaryng Head Neck Surg. 2003; 128:387–395. DOI: 10.1067/mhn.2003.104
- 14. Soumekh B, Levine SC, Haines SJ, Wulf JA. Retrospective study of postcraniotomy headaches in suboccipital approach: diag- nosis and management. Am J Otol. 1996; 17:617–619. https://pubmed.ncbi.nlm.nih.gov/8841709/
- 15. Williams B. A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain. 1978; 101:223–50. DOI: 10.1093/brain/101.2.223
- 16. Duddy MJ, Williams B. Hindbrain migration after decompression for hindbrain hernia: a quantitative assessment using MRI. Br J Neurosurg. 1991; 5:141–52. DOI: 10.3109/02688699108998460
- 17. Sahuquillo J, Rubio E, Poca MA, Rovira A, Rodriguez-Baeza A, Cervera C. Posterior fossa reconstruction: a surgical tech- nique for the treatment of Chiari I malformation and Chiari I/ syringomyelia complex – preliminary results and magnetic resonance imaging quantitative assessment of hindbrain migration. Neurosurgery. 1994; 35:874–884. DOI: 10.1227/00006123-199411000-00011
- 18. Batzdorf U, McArthur DL, Bentson JR. Surgical treatment of Chiari malformation with and without syringomyelia: experi- ence with 177 adult patients. J Neurosurg. 2013; 118:232–242. DOI: 10.3171/2012.10.JNS12305