On multivariate logistic regression, patients with POH were less likely to have preoperative brainstem compression by the tumor (odds ratio = 0.21, p = 0.028) and more likely to have higher opioid requirements during hospitalization (OR = 1.023, p = 0.045).Ĭonclusion The presence of bone spicules in the posterior fossa on postoperative CT did not contribute to headaches following retrosigmoid craniectomy approach for VS resection. Age, gender, body mass index, length of stay, tumor diameter, size of craniectomy, the presence of bone spicules, or the amount of posterior petrous temporal bone removed from drilling did not differ significantly between patients with POH and those without. Twenty-seven (55%) patients had posterior fossa bone spicules detectable on postoperative computed tomography (CT). At latest follow up, 16 (33%) had no headaches, 14 (29%) experienced headaches lasting <3 months, 19 (39%) reported POH lasting ≥3 months. Results Of 64 patients undergoing surgery, 49 had complete data (mean age, 49 years 53% female). Main Outcome Measures Development of POH lasting ≥ 3 months is the primary outcome of this study. Participants Adult patients undergoing VS resection via a retrosigmoid approach between November 2017 and February 2020 were included for this study. Setting The study was conducted at a tertiary skull-base referral center.
We aim to determine risk factors, including whether the presence of bone spicules that influence POH after retrosigmoid VS resection.ĭesign Present study is a retrospective case series. Objectives Dispersion of bone dust in the posterior fossa during retrosigmoid craniectomy for vestibular schwannoma (VS) resection could be a source of meningeal irritation and lead to development of persistent postoperative headaches (POH). Buy Article Permissions and Reprints Abstract
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