Frontal Lobe Herniation After Endoscopic Anterior Skull Base Resection: A Rare Complication

Area of Science:

• Neurosurgery
• Otolaryngology
• Oncology

Background:

• Sinonasal tumors are rare head and neck cancers.
• Endoscopic surgery offers advantages over open approaches but carries risks.
• Cerebral herniation is an underreported complication after endoscopic skull base surgery.

Purpose of the Study:

• To present a case of frontal lobe herniation after endoscopic resection of esthesioneuroblastoma.
• To explore the pathophysiology and management challenges of this rare complication.
• To underscore the importance of multifactorial assessment for optimizing patient outcomes.

Main Methods:

• Case report of a 33-year-old male patient.
• Endoscopic resection of an olfactory esthesioneuroblastoma.
• Analysis of potential contributing factors to cerebral herniation, including meningitis and elevated intracranial pressure.

Main Results:

• The patient developed frontal lobe herniation post-operatively.
• Meningitis and elevated intracranial pressure were identified as potential contributing factors.
• The case highlights the complexity of managing cerebral herniation after endoscopic skull base procedures.

Conclusions:

• Cerebral herniation, though rare, is a significant complication of endoscopic anterior skull base surgery.
• Multifactorial causes, including infection and increased intracranial pressure, must be considered.
• Preoperative identification of risk factors is crucial for optimizing management and improving patient outcomes.