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KMID : 0390220110220020243
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2011 Volume.22 No. 2 p.243 ~ p.246
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A Case of Pneumocephalus and Severe Meningitis as Complications of Endoscopic Sinus Surgery
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Lee Ho-Min
Lee Sang-Min
Lee Jung-Min
Lee Tae-Hoon
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Abstract
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Pneumocephalus represents rare complications in endoscopic sinus surgery. Pneumocephalus following nasal and sinus surgery occurs because of iatrogenic damage to the skull base. Patients with posttraumatic cerebrospinal fluid leakage lasting more than 7 days have at least 8- to 10-fold increase in risk of meningitis. Although treatment regimens for Streptococcus pneumoniae meningitis have improved, the mortality rate remains as high as 25% with neurological sequelae in up to half of survivors. We report a 35-year-old man with pneumocephalus and meningitis as complications of endoscopic sinus surgery. We initially treated the patient by administration of antibiotics and lumbar drain. After controlling inflammation, endoscopic repair of cerebrospinal fluidrhinorrhea with osteomucoperiosteal free flap obtained from the middle turbinate under general anesthesia was done. The patient was followed up without any complication.
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KEYWORD
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Pneumocephalus, Meningitis, Cerebrospinal fluid rhinorrhea, Endoscopic surgery
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