Treatment of pneumocephalus after endoscopic sinus and microscopic skull base surgery

Abstract Background Pneumocephalus is a rare complication of endoscopic sinus surgery (ESS) and microscopic skull base surgery (MSBS). Postoperatively, patients often present with headache and altered mental status. Unrepaired leaks are associated with an increased risk of ascending meningitis. Standard treatment of pneumocephalus after ESS or MSBS has not been addressed in the literature. Methods The study involved a retrospective review of patients at an academic tertiary care center with pneumocephalus after ESS or MSBS. Results Ten cases of pneumocephalus were identified, 8 after ESS and 2 after MSBS. Seven ESS defects were very small (