Department of Anesthesiology, Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA.
Anesth Analg. 2011 Jan;112(1):198-200. doi: 10.1213/ANE.0b013e3181fca689. Epub 2010 Oct 21.
We describe a case of inadvertent intracranial placement of a nasotracheal tube in a patient with an undiagnosed major congenital cranial anomaly (a variant of Goldenhar syndrome, which included absence of the cribriform plate). We believe that this is the first reported case in which this complication arose as a result of a congenital abnormality rather than traumatic or iatrogenic disruption of the skull base. We conclude that patients with known craniofacial abnormalities or associated syndromes scheduled for procedures involving planned nasotracheal intubation or nasogastric tube placement should undergo preoperative cranial imaging studies to verify an intact skull base.
我们描述了一例意外将鼻气管导管插入一名患有未确诊的主要先天性颅面畸形（Goldenhar 综合征的一种变异，包括筛板缺失）患者颅内的病例。我们认为这是首例由于先天性异常而非颅底创伤或医源性损伤而导致这种并发症的报告病例。我们得出结论，对于已知颅面异常或相关综合征的患者，计划进行涉及经鼻气管插管或鼻胃管放置的手术，应进行术前颅部影像学研究以验证完整的颅底。
