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Pneumocephalus with BiPAP use after transsphenoidal surgery
Jonathan C Kopelovich1, Gabriel O de la Garza, Jeremy D W Greenlee
1Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA.
Journal of Clinical Anesthesia
|May 26, 2012
Summary
Bilevel positive airway pressure (BiPAP) can cause serious complications like pneumocephalus after head and neck surgery. Clinicians should exercise caution when using positive airway pressure devices postoperatively in these patients.
Area of Science:
- Neurosurgery
- Pulmonology
- Critical Care Medicine
Background:
- Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) are standard treatments for obstructive sleep apnea.
- The benefits of positive airway pressure (PAP) therapy are well-established, but complications are rarely reported.
Observation:
- A patient developed severe pneumocephalus and required intensive care unit admission after receiving postoperative BiPAP.
- The patient underwent transsphenoidal craniopharyngioma resection.
Findings:
- Postoperative BiPAP was associated with the development of severe pneumocephalus.
- The pneumocephalus resolved with conservative management within two weeks.
Implications:
- Positive airway pressure therapy, including BiPAP and CPAP, should be used with caution in the postoperative period for patients undergoing head and neck procedures.
- Further investigation into the risks and benefits of postoperative PAP therapy in specific surgical populations is warranted.
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