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Tension pneumocephalus secondary to osteoradionecrosis of the clivus
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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.
Keywords
Tension pneumocephalus (TP); Nasopharyngeal carcinoma (NPC); Skull-base fistula; Endoscopic endonasal approach
About this articleTitle
Tension pneumocephalus secondary to osteoradionecrosis of the clivus
Journal
Reports of Practical Oncology and Radiotherapy
Issue
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