Postoperative Headache after Undergoing Acoustic Neuroma Surgery via the Retrosigmoid Approach

摘要

To estimate the duration of postoperative headache after surgery for acoustic neuroma and the effects of age, sex, tumor size, extent of tumor resection, type of skin incision, surgical duration, hearing preservation, and postoperative facial nerve palsy. This retrospective review analyzed clinical data from 97 patients who had undergone surgery for unilateral acoustic neuroma via the retrosigmoid approach >1 year previously. We investigated whether patients had headache at hospital discharge and during attendance at outpatient clinics. We classified postoperative headache as grade 0 (no headache), 1 (tolerable headache without medication), or 2 (headache requiring medication). The period of headache was defined as the interval in days between surgery and achievement of grade 0. The period of medication for headache was defined as the interval in days between surgery and achievement of grade 0 or 1. Kaplan-Meier analysis revealed median durations of medication and headache of 81 and 641 days, respectively. Headache was cured significantly earlier in patients who underwent surgery using a C-type skin incision (P < 0.001). Headache persisted significantly longer among patients who underwent a shorter surgical procedure (P < 0.02). Multivariate analysis confirmed the type of skin incision as a factor independently associated with duration of postoperative headache. Postoperative headache was cured in the majority of patients within about 2 years after surgery. The C-type skin incision is likely beneficial for reducing the duration of postoperative headache, although headache persisted in a small number of patients.