Iatrogenic Pulsatile Tinnitus Resulting from Dural Dehiscence

Area of Science:

• Neurosurgery
• Otolaryngology
• Cranial Surgery

Background:

• Pulsatile tinnitus is a rare complication following retrosigmoid craniotomy.
• Microvascular trigeminal nerve decompression is a standard surgical procedure.
• Pneumatocele formation can occur after cranial defect repair.

Observation:

• A 72-year-old female experienced pulsatile tinnitus post-retrosigmoid craniotomy.
• Imaging revealed a large pneumatocele beneath the craniotomy site.
• The patient's symptoms were attributed to the post-surgical defect.

Findings:

• Surgical repair of the pneumatocele was necessary.
• Cranioplasty and mastoid obliteration were performed to address the defect.
• The combined surgical approach aimed to resolve the tinnitus and close the defect.

Implications:

• Successful management of post-craniotomy pneumatocele is crucial for patient recovery.
• This case highlights the importance of addressing cerebrospinal fluid leaks and air-fluid interfaces.
• Effective surgical techniques can prevent long-term complications like pulsatile tinnitus.