Objective: Characterize the incidence, risk factors, and patient outcomes of dural venous sinus thrombosis identified on postoperative imaging after retrosigmoid or translabyrinthine craniotomy for vestibular schwannoma resection.
Study design: Retrospective cohort study.
Setting: Single tertiary academic referral center.
Patients: Eighty-one patients 19 to 82 years of age with vestibular schwannomas, 58% female.
Interventions: Retrosigmoid or translabyrinthine craniotomy with postoperative magnetic resonance imaging/magnetic resonance venography.
Main outcome measures: Association between operative approach, age, sex, body mass index, tumor size, dominant sinus, operative time, laterality, and perioperative cerebrospinal fluid (CSF) leaks with rate of thrombosis.
Results: Translabyrinthine craniotomy was associated with the highest relative risk of thrombosis (odds ratios [OR] = 19.82, 95% confidence interval [CI] = 1.75-224, p = 0.007), followed by male sex (OR = 5.53, 95% CI = 1.63-18.8, p = 0.035). Other patient and demographic risk factors were not associated with increased rates of dural venous thrombosis, nor was there an association with postoperative CSF leak. 81% (25/31) of thrombi had resolved within 3 years of surgery.
Conclusions: Translabyrinthine approach and male sex most strongly predicted postoperative dural venous thrombosis after postauricular craniotomy for vestibular schwannoma resection.
Professional practice gap and educational need: Better understanding of risk factors and management of dural venous thrombosis after vestibular schwannoma surgery.
Learning objective: Characterize clinically significant risk factors for dural venous thrombosis in vestibular schwannoma surgery.
Desired result: Identification of patient and operative risk factors for dural venous thrombosis.
Level of evidence: III.
Indicate irb or iacuc: Exempt.
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