Retrosigmoid craniotomy for microvascular decompression (MVD) has been traditionally performed via craniectomy. Various closure techniques have been described, yet factors associated with wound-related complications remain undetermined. Accordingly, herein, we sought to identify risk factors associated with wound-related complications after such procedures. An institutional retrospective case-control study was performed; outcomes of interest were cerebrospinal fluid (CSF) leak, wound dehiscence, wound infection, and pseudomeningocele. Univariate analysis was performed using Wilcoxon rank sum test for non-parametric continuous outcomes and chi-square test for categorical outcomes. Multivariate logistic regression was performed on binomial outcome variables. The study population included 197 patients who underwent MVD for trigeminal neuralgia (83.2%), hemifacial spasm (12.2%), vestibular nerve section (3.0%), and glossopharyngeal neuralgia (1.5%). The overall wound-related complication rate was 14.2% (n = 28), including twelve patients (6.1%) with CSF leak, ten patients (5.1%) with wound infection, ten patients (5.1%) with pseudomeningocele, and nine (4.6%) patients with wound dehiscence. Using multivariate logistic regression, preoperative anemia and current tobacco use were associated with significantly higher rates of complications (OR 6.01 and 4.58, respectively; p < 0.05), including CSF leak (OR 12.83 and 12.40, respectively, p < 0.05). Of note, use of synthetic bone substitute for cranioplasty was associated with a significantly lower rate of complications (OR 0.13, p < 0.01). Preoperative anemia and current tobacco use significantly increased, while synthetic bone substitute cranioplasty significantly decreased, odds of wound-related complications, the need for treatment, and CSF leaks. Additionally, higher BMI, longer operative duration, and prior radiosurgery may increase risk for wound-related complications.

中文翻译：

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微血管减压后伤口相关并发症的危险因素。

传统上通过颅骨切除术进行后乙状窦后开颅手术以进行微血管减压（MVD）。已经描述了各种闭合技术，但是尚未确定与伤口相关并发症相关的因素。因此，本文中，我们试图确定与此类手术后的伤口相关并发症相关的危险因素。进行了一项机构回顾性病例对照研究。感兴趣的结局是脑脊液（CSF）泄漏，伤口裂开，伤口感染和假性脑膜膨出。使用Wilcoxon秩和检验进行非参数连续结果进行单变量分析，对分类结果进行卡方检验进行单变量分析。对二项式结果变量进行多元逻辑回归。研究人群包括197例因三叉神经痛而接受MVD的患者（83。2％），面肌痉挛（12.2％），前庭神经节（3.0％）和舌咽神经痛（1.5％）。总体伤口相关并发症发生率为14.2％（n = 28），其中包括12例（6.1％）的CSF漏诊，10例（5.1％）的伤口感染，10例（5.1％）的假性脑膜膨出和9例（4.6） ％）伤口裂开的患者。使用多元逻辑回归分析，术前贫血和当前使用烟草与并发症发生率显着更高（分别为OR 6.01和4.58； p <0.05），包括脑脊液漏（分别为OR 12.83和12.40，p <0.05）。值得注意的是，使用人工骨替代颅骨成形术可显着降低并发症发生率（OR 0.13，p <0.01）。术前贫血和目前的烟草使用量显着增加，人工骨替代颅骨成形术明显减少，与伤口相关的并发症发生几率，治疗需求和脑脊液渗漏。此外，较高的BMI，更长的手术时间和先前的放射外科手术可能会增加伤口相关并发症的风险。