Dural Sinus Thrombosis after Translabyrinthine Approach for Vestibular Schwannomas

Background: Translabyrinthine (TL) approach has been a well-established procedure for excision of vestibular schwannomas (VS) in neurosurgery. The primary objective of our study was to estimate the incidence of both symptomatic as well as asymptomatic dural sinus thrombosis (DST) of transverse and sigmoid sinuses after TL approach. Methods: This is a retrospective study (undergoing) including all patients of VS operated by the TL approach during the past 2 years at our institute. All patients had either postoperative CT head with contrast on POD1 and subsequent MR or CT with contrast within 3 months of surgery. Patients with DST had follow-up CT venogram in 3 to 4 months postsurgery. The minimum follow-up was 4 months. Results: We anticipate about 50 patients operated upon by the translabyrinthine approach in this period. The final results of the study will be available in next 2 months although initial analysis suggests the following:(1) DST is not rare, (2) most of the DST after TL approach seems to be asymptomatic requiring no further treatment, and (3) most DST become patent (at least partially) in long-term CT venogram follow-up. Conclusion: TL approach is a suitable approach for excision of vestibular schwannomas. Although, this approach predisposes patients for dural sinus thrombosis, symptomatic DST is rare.