Analysis of Clinical Implications of Aeroembolism in Patients with CPA Tumor Operated in Sitting Position

Introduction: The sitting position of the patient during the cerebellopontine angle (CPA) surgery enables spontaneous outflow of blood and cerebrospinal fluid from the operation site. This restricts the necessity of aspirating nozzle and other instruments which are dangerous for local delicate structures like the facial nerve or labyrinthine artery. The disadvantage of this position is risk of pneumatocele and aeroembolism. Purpose: The aim of this study was to find the influence of aeroembolism on clinical outcome of patients with CPA tumor. Material and Methods: Two hundred forty-six patients operated in the Department of Neurosurgery Medical University of Silesia in Katowice were analyzed. Aeroembolism was correlated with such parameters as: death rate, duration of hospitalization in neurosurgical and intensive care wards, respiratory or circulatory insufficiency, necessity of usage of respirator, and the number of other specialists' consultations. Results: Aeroembolism appeared in 10% of patients. It doesn't increase the death rate, duration of hospitalization in the neurosurgical ward, or circulatory insufficiency, but it exposes patients to respiratory failure (p = 0.014), prolonged hospitalization in the intensive care ward (p = 0.002), and it increases the number of specialists' consultations (p = 0.042). Conclusions: Patients' sitting position in CPA tumor surgery, especially in vestibular schwannoma cases, doesn't implicate very negatively in clinical status and enables surgeons to obtain good results of procedure, such as facial nerve function and hearing preservation.