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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Supraorbital keyhole approach to the skull base: Evaluation of complications related to CSF fistulas and opened frontal sinus

Meeting Abstract

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  • Firas Thaher - Klinik für Neurochirurgie, Klinikum Stuttgart, Stuttgart, Deutschland
  • Anne-Katrin Hickmann - Klinik für Neurochirurgie, Klinikum Stuttgart, Stuttgart, Deutschland
  • P. Kurucz - Klinik für Neurochirurgie, Klinikum Stuttgart, Stuttgart, Deutschland
  • Markus Bittl - Klinik für Neurochirurgie, Klinikum Stuttgart, Stuttgart, Deutschland
  • Hans Henkes - Abteilung für Neuroradiologie, Klinikum Stuttgart, Stuttgart, Deutschland
  • Nikolai J. Hopf - Klinik für Neurochirurgie, Klinikum Stuttgart, Stuttgart, Deutschland
  • Günther C. Feigl - Klinik für Neurochirurgie, Klinikum Stuttgart, Stuttgart, Deutschland; Klinik für Neurochirurgie, Klinikum Bamberg, Bamberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.15.11

doi: 10.3205/14dgnc216, urn:nbn:de:0183-14dgnc2169

Published: May 13, 2014

© 2014 Thaher et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: The cerebral spinal fluid (CSF) leak due to an opening in the frontal sinus (FS) present one of the main postoperative complications of the supraorbital keyhole approach. The goal of this study was to analyze the possible influence of the surgical techniques used for the supraorbital keyhole approach on the frequency of post-operative CSF leaks and compare the data to current literature.

Method: A total of 350 consecutive patients who underwent surgeries via the supraorbital keyhole approach for various lesions were included in this retrospective study. Information on clinical history, neurological symptoms, surgical approach, and postoperative complication was obtained retrospectively by review of the patients' charts, the radiological reports and a thorough review of pre- and postoperative imaging.

Results: Analysis of all postoperative CCT scan revealed that 88 patients (25.1%) out of the 350 with supraorbital craniotomies showed a radiographic opening of the FS. Eight of these patients (2.3%) developed a CSF leak with rhinorrhea postoperatively, of which one patient (0.3%) also developed meningitis.

Conclusions: Inadvertent opening of the FS during the supraorbital craniotomy is a common surgery related morbidity however the risk for the patient to develop a potentially dangerous meningitis was found to be minimal.