From the Research
Post-operative restrictions after a craniotomy for semicircular canal dehiscence typically include avoiding strenuous physical activity for 4-6 weeks, no heavy lifting (over 10 pounds), and no bending or straining that increases intracranial pressure. Patients should sleep with their head elevated at 30-45 degrees for the first week to reduce swelling and pressure 1. Air travel should be avoided for 2-4 weeks, as should activities that create pressure changes like scuba diving or skydiving for at least 3 months. Patients should not blow their nose forcefully and should sneeze with their mouth open to prevent pressure buildup in the ear. Driving is typically restricted until cleared by the surgeon, usually 2-4 weeks post-surgery. Pain management typically includes acetaminophen and possibly prescribed opioids for the first few days, while avoiding NSAIDs like ibuprofen which can increase bleeding risk.
Key Considerations
- Avoiding strenuous physical activity for 4-6 weeks is crucial to prevent complications like CSF leak or infection 2, 3.
- Sleeping with the head elevated at 30-45 degrees for the first week can help reduce swelling and pressure 1.
- Avoiding activities that create pressure changes, such as scuba diving or skydiving, for at least 3 months is essential to prevent displacement of materials used to repair the dehiscence.
- Patients should follow up with their surgeon for clearance to resume normal activities, usually after 6-8 weeks, though some vestibular symptoms like dizziness may persist longer and require vestibular rehabilitation therapy 4.
Symptom Management
- Vestibular symptoms like dizziness may persist longer and require vestibular rehabilitation therapy 2, 3.
- Auditory symptoms like hearing loss, pulsatile tinnitus, and autophony may improve after surgery, but some patients may experience persistent symptoms 5, 1.
- Patients should be monitored for complications like CSF leak, infection, or displacement of materials used to repair the dehiscence, and report any concerns to their surgeon promptly.