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Updated: Jul 16, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Translabyrinthine Craniotomy Is Associated with Higher Risk of Asymptomatic Dural Venous Sinus Thrombosis in
Hunter L Elms1, David M Straka, Dina K Abouelella
1Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, North Carolina.
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.
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