• Satya Deo Pandey, Anant Mehrotra, Kuntal Kanti Das, Kamlesh Singh Bhaisora, Jayesh Sardhara, Pradeep Sharma, Suyash Singh, Arun Kumar Srivastava, Rabi Narayan Sahu, Awadesh Kumar Jaiswal, Sanjay Behari, and Raj Kumar.
• Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
• World Neurosurg. 2017 Jun 1; 102: 28-34.

ObjectiveTo study factors influencing oro-facial herpetic eruptions (HEs) in patients undergoing retromastoid suboccipital craniectomy for vestibular schwannomas (VS).MethodsA retrospective analysis of the prospectively collected database (from July 2014 to December 2015). A total of 87 patients underwent retromastoid suboccipital craniectomy for VS at our center. For the purpose of analysis the patient subset was divided into 2 groups, HE and non-HE. Pearson χ2 test or Fisher exact test were used to identify the factors.ResultsThe overall incidence of postoperative HE was less than 1% (0.89%, 26 patients of 2916 cases); whereas after VS surgery, it was 20.69% (18 of 87). Demographic profiles of patients in the 2 groups were comparable. Average tumor size (with HE 3.19 ± 2 × 0.67 cm, non-HE 3.38 ± 2 × 1.07 cm), consistency, and laterality also were comparable between the 2 groups. Factors favoring development of postoperative HEs were large size (12 vs. 22, P = 0.013) and preoperative trigeminal nerve (CN V) involvement (9 of 18, 50%, P = 0.046). All patients developed HE in maxillary division of trigeminal nerve (V2), whereas involvement of ophthalmic (V1) and mandibular (V3) divisions were involved less commonly in combination with V2 (V2, 72.2%; V2 + V3, 22.2%; V1 + V2 + V3, 5.6%). The majority of the patients (55.56%) developed HE on postoperative day 3 and none beyond postoperative day 5. All patients responded to empirical oral acyclovir.ConclusionsThe study highlights the relatively high incidence and factors associated with this rare but benign complication.Copyright © 2017 Elsevier Inc. All rights reserved.

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