TY - JOUR
T1 - CSF leakage and anosmia in aneurysm clipping of anterior communicating artery by basal interhemispheric approach
AU - Nakayama, Hirobumi
AU - Ishikawa, Tastuya
AU - Yamashita, Shingo
AU - Fukui, Issei
AU - Mutoh, Tatsushi
AU - Hikichi, Kentaro
AU - Yoshioka, Shotaro
AU - Kawai, Hideya
AU - Tamakawa, Noriyuki
AU - Moroi, Junta
AU - Suzuki, Akifumi
AU - Yasui, Nobuyuki
PY - 2011/3/10
Y1 - 2011/3/10
N2 - We studied the incidence of postoperative infection related to CSF leakage and anosmia in basal interhemispheric approach (BIH). Between April, 1990 to March, 2009, 142 cases of anterior communicating (Acom) aneurysm including both unruptured and ruptured have been treated by clipping surgery using BIH. We retrospectively obtained clinical informations from medical records and video records about infectious complications, CSF leakage of cerebrospinal fluid (CSF), olfactory dysfunction and intraoperative findings of damage to the olfactory nerve. In most cases (139 patients, 97%), frontal sinus were opened at craniotomy. Of all, CSF rinorrhea occurred in 4 cases (2.8%), and meningitis in 6 cases. There was only one patient who sufferd from meningitis due to CSF rinorrhea. All that patients recovered completely without deficit. Anosmia occurred in 6 cases (4.2%). and intraoperative injuries in 4 cases (2.8%). There was only one patient in whom anosmia was consistent with nerve injury. In conclusion, BIH is an appropriate procedure for infection risk control in Acom aneurysm surgery. It is difficult to avoid olfactory dysfunction completely, even if olfactory nerves are preserved in form.
AB - We studied the incidence of postoperative infection related to CSF leakage and anosmia in basal interhemispheric approach (BIH). Between April, 1990 to March, 2009, 142 cases of anterior communicating (Acom) aneurysm including both unruptured and ruptured have been treated by clipping surgery using BIH. We retrospectively obtained clinical informations from medical records and video records about infectious complications, CSF leakage of cerebrospinal fluid (CSF), olfactory dysfunction and intraoperative findings of damage to the olfactory nerve. In most cases (139 patients, 97%), frontal sinus were opened at craniotomy. Of all, CSF rinorrhea occurred in 4 cases (2.8%), and meningitis in 6 cases. There was only one patient who sufferd from meningitis due to CSF rinorrhea. All that patients recovered completely without deficit. Anosmia occurred in 6 cases (4.2%). and intraoperative injuries in 4 cases (2.8%). There was only one patient in whom anosmia was consistent with nerve injury. In conclusion, BIH is an appropriate procedure for infection risk control in Acom aneurysm surgery. It is difficult to avoid olfactory dysfunction completely, even if olfactory nerves are preserved in form.
KW - Anosmia
KW - BIH
KW - CSF leakage
KW - Infection
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M3 - Article
C2 - 21372335
AN - SCOPUS:79953179327
VL - 39
SP - 263
EP - 268
JO - Neurological Surgery
JF - Neurological Surgery
SN - 0301-2603
IS - 3
ER -