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Had MVD surgery. Done with CT scan. What are the findings in the report?

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Left side: External auditory canal is unremarkable. Mastoids are well
developed and well aerated. There is a small defect in the posterior
aspect of the left mastoid air cells, which is contiguous with the
left suboccipital craniectomy defect. Minimal soft tissue in the left
mastoids at the site of the defect is noted. Defect is well corticated
in appearance. No adjacent soft tissue abnormalities. Mastoids are
otherwise clear. Tympanic membrane is not retracted. Middle ear cavity
is clear. Scutum and tegmen tympani are intact. Ossicles appear
intact. Inner ear structures are unremarkable. Bony XXXXXXX auditory
canal is unremarkable.
had mvd surgery, followed by surgery for csf leak. just received these results from ct scan and am unsure if it is something to be concerned about.
Posted Mon, 11 Nov 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 4 hours later
Brief Answer:
There is no cause for worry.

Detailed Answer:
Hi,

Thank you for your query.

1. The Scan report seems fine. If you need a detailed review, you may upload the images.

2. CSF leak following Micro Vascular Decompression (MVD) surgery is a known complication. The mastoids are clear. XXXXXXX leaks will require a CT Cisternography to detect. This should be done, if required, after conservative (medical) management for at least two weeks.

3. If there is no active CSF leak, there is no cause for worry.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had MVD surgery. Done with CT scan. What are the findings in the report? 13 minutes later
Forgot to mention I have had several infections. Is tissue in mastoid as well as craniotomy expected? I do have a csf leak from 3weeks of lumbar drain but am scheduled for 2nd blood patch Monday. Don't know if that matters. Thanks
 
 
Answered by Dr. Sumit Bhatti 10 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Inadvertent opening of the mastoid air cells during a retromastoid craniotomy is commonly seen when there is extensive pneumatization of the mastoid air cell system. Hence if this has happened during the surgery, tissue is expected in the mastoid as well as the craniotomy.

2. The CSF leak is a known complication in up to 10% of operated patients. However, a leak persisting in spite of a lumbar drain for 3 weeks suggests a large leak which must be repaired.

3. Several infections means that the repair should be done early.

4. The CT Cisternography may help locate the exact site of the leak. In many patients, air enters the skull (pneumatocele) as the CSF leaks out (as is commonly seen after trauma or accidents).

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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