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Postcraniectomy pain: comparison between 2 incisions for the retrosigmoid approach. Prospective randomized study
Emiliano Lorefice1, Francisco Marcó Del Pont1, Sebastián J M Giovannini1
1Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina.
Neurocirugia (English Edition)
|April 1, 2020
Summary
The modified Dandy incision for suboccipital lateral approaches may increase postcraniectomy headache rates compared to the classical linear incision. Further research is needed to confirm these findings for vestibular neurinoma surgery.
Area of Science:
- Neurosurgery
- Surgical Techniques
- Pain Management
Background:
- The suboccipital lateral approach is standard for cerebellopontine angle exposure in neurosurgery.
- Postcraniectomy headache (PCH) is a common complication impacting patient quality of life.
Purpose of the Study:
- To compare postcraniectomy pain following vestibular neurinoma surgery using two distinct suboccipital lateral approach incisions.
- Evaluate the impact of different surgical incisions on patient-reported pain and quality of life.
Main Methods:
- Prospective randomized study of 40 patients undergoing vestibular neurinoma surgery.
- Comparison between classical linear incision (n=20) and modified Dandy (inverted "U") incision (n=20).
- Pain assessed via numerical scale; quality of life via SF-36 questionnaire; minimum 3-month follow-up.
Main Results:
- Overall PCH incidence was 27.5% (11/40 patients).
- The modified Dandy incision group showed a higher pain incidence (35%) compared to the classical incision group (20%).
Conclusions:
- Preliminary findings suggest the modified Dandy incision may be associated with a higher rate of post-craniectomy headache.
- Further investigation with larger sample sizes is recommended.
- Interdisciplinary follow-up is advised for comprehensive PCH management.
