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Translabyrinthine Craniotomy Is Associated with Higher Risk of Asymptomatic Dural Venous Sinus Thrombosis in Vestibular Schwannoma Resection. Otol Neurotol 2023 Dec 01;44(10):1066-1072

Date

09/12/2023

Pubmed ID

37696795

DOI

10.1097/MAO.0000000000004013

Scopus ID

2-s2.0-85176509377 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

OBJECTIVE: Characterize the incidence, risk factors, and patient outcomes of dural venous sinus thrombosis identified on postoperative imaging after retrosigmoid or translabyrinthine craniotomy for vestibular schwannoma resection.

STUDY DESIGN: Retrospective cohort study.

SETTING: Single tertiary academic referral center.

PATIENTS: Eighty-one patients 19 to 82 years of age with vestibular schwannomas, 58% female.

INTERVENTIONS: Retrosigmoid or translabyrinthine craniotomy with postoperative magnetic resonance imaging/magnetic resonance venography.

MAIN OUTCOME MEASURES: Association between operative approach, age, sex, body mass index, tumor size, dominant sinus, operative time, laterality, and perioperative cerebrospinal fluid (CSF) leaks with rate of thrombosis.

RESULTS: Translabyrinthine craniotomy was associated with the highest relative risk of thrombosis (odds ratios [OR] = 19.82, 95% confidence interval [CI] = 1.75-224, p = 0.007), followed by male sex (OR = 5.53, 95% CI = 1.63-18.8, p = 0.035). Other patient and demographic risk factors were not associated with increased rates of dural venous thrombosis, nor was there an association with postoperative CSF leak. 81% (25/31) of thrombi had resolved within 3 years of surgery.

CONCLUSIONS: Translabyrinthine approach and male sex most strongly predicted postoperative dural venous thrombosis after postauricular craniotomy for vestibular schwannoma resection.

PROFESSIONAL PRACTICE GAP AND EDUCATIONAL NEED: Better understanding of risk factors and management of dural venous thrombosis after vestibular schwannoma surgery.

LEARNING OBJECTIVE: Characterize clinically significant risk factors for dural venous thrombosis in vestibular schwannoma surgery.

DESIRED RESULT: Identification of patient and operative risk factors for dural venous thrombosis.

LEVEL OF EVIDENCE: III.

INDICATE IRB OR IACUC: Exempt.

Author List

Elms HL, Straka DM, Abouelella DK, Francis HW, Kaylie DM, Cunningham CD 3rd

Author

Hunter L. Elms BS, MD Assistant Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cerebrospinal Fluid Leak
Craniotomy
Female
Humans
Male
Neuroma, Acoustic
Postoperative Complications
Retrospective Studies
Sinus Thrombosis, Intracranial
Venous Thrombosis