Orbital emphysema after endoscopic third ventriculostomy and posterior fossa surgery in the sitting position.
BACKGROUND
Orbital emphysema can be associated with optic nerve and vascular compromise, with subsequent potentially irreversible visual loss.


METHODS
We report a 4-year-old girl who presented right orbital emphysema after posterior fossa surgery for pilocytic astrocytoma resection in the sitting position. Endoscopic third ventriculostomy (ETV) had been previously carried out for the treatment of symptomatic obstructive hydrocephalus. Our hypothesis is that periorbital emphysema developed due to air passing from the intracranial to the extracranial compartment through the ETV burr hole.


CONCLUSIONS
The emphysema resolved spontaneously without any sequelae. To our knowledge, this is the first description of orbital emphysema after posterior fossa surgery in the sitting position.
Solivera
Juan
J
Department of Neurosurgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. jsolivera@santpau.es
Navarro
Ramón
R
Costa
Josep Maria
JM
D001254:Astrocytoma / Q000150:complications / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000379:methods; D009916:Orbital Diseases / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011187:Posture; D020542:Third Ventricle / Q000601:surgery; D014696:Ventriculostomy