Orbital emphysema after endoscopic third ventriculostomy and posterior fossa surgery in the sitting position.

摘要

INTRODUCTION: Orbital emphysema can be associated with optic nerve and vascular compromise, with subsequent potentially irreversible visual loss. MATERIALS AND 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. RESULT AND DISCUSSION: 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.