Novel Siphon Tube Technique in the Surgical Evacuation of Chronic Subdural Hematoma

Abstract Most reported complications of surgical evacuation for chronic subdural hematoma (CSDH) are recurrence and pneumocephalus. We proposed the Siphon tube technique as an alternative to traditional irrigation methods to reduce recurrence after Burr–Hole Craniotomy (BHC). In this observational study of 120 patients who underwent surgery for CSDH, we evaluated the effectiveness of this modified BHC with the Siphon technique in evacuation of hematomas, recurrence, and pneumocephalus. The average age of the study population was 66.41 ± 12.02 (41–90 years), with 112 (93.3%) men. Among co-morbidities, 75 (62.5%) were known hypertensives and 45 (37.5%) were known patients with type 2 diabetes. While 28 (23.3%) had a history of cardiac disease, two (1.7%) patients were diagnosed with chronic kidney disease. Laterality of CSDH was right-sided in 36 (30.0%). Left in 51 (42.5%) and bilateral in 33 (27.5%) patients. The average length of stay in the hospital was 3.65 ± 2.35 days. On follow-up, recurrence was observed in two (1.7%) patients and pneumocephalus in 10 (8.3%) patients. On comparison between groups based on pneumocepalus, there were no significant differences between the groups for demographic, clinical, surgical, and outcome parameters. In patients with CSDH, the proposed Siphon tube irrigation technique as an alternative to traditional irrigation methods during BHC promises to be effective in minimizing pneumocephalus and recurrence. Our findings should be evaluated in larger multi-center studies.