Pyogenic Ventriculitis After Anterior Skull Base Surgery Treated With Endoscopic Ventricular Irrigation And Reconstruction Using a Vascularized Flap

Yusuke Tomita, Yosuke Shimazu, Masato Kawakami, Hiroshi Matsumoto, Kentaro Fujii, Masahiro Kameda, Takao Yasuhara, Yasuki Suruga, Tomoyuki Ota, Yoshihiro Kimata, Kazuhiko Kurozumi, Isao Date, Yusuke Tomita, Yosuke Shimazu, Masato Kawakami, Hiroshi Matsumoto, Kentaro Fujii, Masahiro Kameda, Takao Yasuhara, Yasuki Suruga, Tomoyuki Ota, Yoshihiro Kimata, Kazuhiko Kurozumi, Isao Date

Abstract

Ventriculitis is a rare, serious complication of neurosurgery. A 59-year-old man who had undergone a craniotomy for a paranasal adenocarcinoma, developed a right frontal cystic lesion. We performed a bifrontal craniotomy to remove the lesion. The dura was repaired with non-vascularized free fascia lata in watertight fashion. Ventriculitis occurred 3 days postoperatively. Ventricular drainage, craniectomy, and endoscopic irrigation were undertaken to remove an abscess. The dura and the resection cavity were reconstructed using a vascularized anterolateral thigh adipofascial flap. His symptoms disappeared, indicating that endoscopic irrigation and reconstruction can effectively address ventriculitis even in patients in critical clinical condition.

Keywords: anterior skull base surgery; intraventricular antimicrobial therapy; surgical site infection; ventriculitis.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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Source: PubMed

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