open access

Vol 21, No 1 (2016)
Published online: 2016-01-01
Submitted: 2015-04-01
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Tension pneumocephalus secondary to osteoradionecrosis of the clivus

Andrea Risso, Cesare Zoia, Carlo Gianformaggio, Fabio Pagella, Alessandro Pusateri, Marco Benazzo, Paolo Gaetani
DOI: 10.1016/j.rpor.2015.05.007
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Rep Pract Oncol Radiother 2016;21(1):71-75.

open access

Vol 21, No 1 (2016)
Published online: 2016-01-01
Submitted: 2015-04-01

Abstract

We report the case of a 36 year-old man with relapsing undifferentiated nasopharyngeal carcinoma treated with a re-irradiation Cyberknife, who subsequently developed tension pneumocephalus due to a cerebrospinal fluid leakage located at the clivus. The fistula was caused by osteonecrosis of the skull base secondary to the tumor invasion and to the sequelae of the radiotherapy. An endoscopic endonasal technique was used in order to repair the defect, with a peduncolated nasoseptal flap harvested to perform the skull base reconstruction. In this paper, we discuss the importance of identifying this possible complication related to radiotherapy in the management of neoplasm along the skull base; moreover, the role of endoscopy in the diagnosis and treatment of skull base fistulas is also described and commented.

Abstract

We report the case of a 36 year-old man with relapsing undifferentiated nasopharyngeal carcinoma treated with a re-irradiation Cyberknife, who subsequently developed tension pneumocephalus due to a cerebrospinal fluid leakage located at the clivus. The fistula was caused by osteonecrosis of the skull base secondary to the tumor invasion and to the sequelae of the radiotherapy. An endoscopic endonasal technique was used in order to repair the defect, with a peduncolated nasoseptal flap harvested to perform the skull base reconstruction. In this paper, we discuss the importance of identifying this possible complication related to radiotherapy in the management of neoplasm along the skull base; moreover, the role of endoscopy in the diagnosis and treatment of skull base fistulas is also described and commented.

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Keywords

Tension pneumocephalus (TP); Nasopharyngeal carcinoma (NPC); Skull-base fistula; Endoscopic endonasal approach

About this article
Title

Tension pneumocephalus secondary to osteoradionecrosis of the clivus

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 1 (2016)

Pages

71-75

Published online

2016-01-01

DOI

10.1016/j.rpor.2015.05.007

Bibliographic record

Rep Pract Oncol Radiother 2016;21(1):71-75.

Keywords

Tension pneumocephalus (TP)
Nasopharyngeal carcinoma (NPC)
Skull-base fistula
Endoscopic endonasal approach

Authors

Andrea Risso
Cesare Zoia
Carlo Gianformaggio
Fabio Pagella
Alessandro Pusateri
Marco Benazzo
Paolo Gaetani

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