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Perioperative lumbar drain placement: An independent predictor of tension pneumocephalus and intracranial complications following anterior skull base surgery

✍ Scribed by Jon-Paul Pepper; Erin M. Lin; Stephen E. Sullivan; Lawrence J. Marentette


Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
142 KB
Volume
121
Category
Article
ISSN
0023-852X

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✦ Synopsis


Abstract

Objective:

To measure the effect of routine perioperative lumbar drain placement during anterior skull base surgery on the frequency of: 1) tension pneumocephalus and 2) total intracranial complications.

Design:

Retrospective review of a series of patients (n = 161) who underwent the transglabellar/subcranial approach to lesions of the anterior skull base between December 1995 and November 2009. A retrospective cohort (n = 45) underwent routine lumbar drain placement at the time of skull base surgery. The remainder of the series did not undergo routine perioperative lumbar drain placement.

Intervention:

Transglabellar/subcranial surgical approach to the anterior skull base, with or without routine perioperative lumbar drain placement.

Results:

Routine placement of perioperative lumbar drains was an independent predictor of tension pneumocephalus (P =.022, odds ratio = 11.22 [1.218–103.3]). In addition, this practice was also associated with an increased risk of intracranial complications overall (P =.025, odds ratio = 2.623 [1.104–6.233]).

Conclusion:

Routine placement of perioperative lumbar drain may be associated with an increased risk of tension pneumocephalus and intracranial complications during surgery of the anterior cranial base. Laryngoscope, 2011