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Delayed Progressive Extradural Pneumatocele due to Incomplete Sealing of Opened Mastoid Air Cell after Micro-Vascular

Ki-Sun Hong1, Kwan Park

  • 1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Journal of Korean Neurosurgical Society
|July 10, 2010
PubMed

Insights

A rare complication of posterior fossa surgery, progressive extradural pneumatocele, can occur without cerebrospinal fluid leakage after microvascular decompression. Surgical repair with muscle patch and glue effectively resolved symptoms and prevented recurrence.

Area of Science:

  • Neurosurgery
  • Neurology

Background:

  • Microvascular decompression (MVD) is a standard treatment for hemifacial spasm.
  • Post-surgical complications, though rare, require thorough understanding and management.
  • Extradural pneumatoceles are an uncommon post-operative finding.

Observation:

  • A 60-year-old male developed delayed progressive extradural pneumatocele one month after MVD for hemifacial spasm.
  • The patient presented with tinnitus and observed extradural pneumatoceles without cerebrospinal fluid (CSF) leakage.
  • The pneumatocele originated from an inadequately sealed mastoid air cell opened during the initial MVD.

Findings:

  • Revision surgery involving complete sealing of the mastoid air cell with a muscle patch and glue successfully treated the condition.
  • The patient experienced symptom resolution and showed no pneumatocele recurrence at a 6-month follow-up.

Implications:

  • Delayed progressive extradural pneumatocele is a rare but significant complication following posterior fossa surgery, particularly MVD.
  • Meticulous sealing of the mastoid air cell during MVD is crucial to prevent this complication.
  • Effective surgical management can lead to favorable outcomes for patients experiencing this rare condition.
Keywords:
Hemifaical spasmMastoid air cellPneumatocelePosterior fossa surgery

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