Güvenç Gönül, Eren Erdem, Arslanoğlu Seçil, Yüceer Nurullah
From the *Departments of Neurosurgery and †Otolaryngology, İzmir Katip Çelebi Atatürk Research and Education Hospital, Izmir, Turkey.
J Craniofac Surg. 2014 Jul;25(4):e360-1. doi: 10.1097/SCS.0000000000000804.
This paper describes a tension pneumocephalus without cerebrospinal fluid leak, a rare complication of septoplasty. We present a case of tension pneumocephalus without cerebrospinal fluid leak 1 month after a septoplasty operation. Although endoscopic sinus surgery can be utilized for repair of the defect, intracranially displaced ethmoid bone fragment makes an open approach more feasible. His postoperative course was uneventful and postoperative CT scan revealed no signs of pneumocephalus. Absence of cerebrospinal fluid leak made this case unique in presentation and caused a delay in diagnosis. Severe headache after septoplasty should alert the surgeon to investigate possible intracranial complications.
本文描述了一例无脑脊液漏的张力性气颅，这是鼻中隔成形术罕见的并发症。我们报告了一例鼻中隔成形术后1个月出现无脑脊液漏的张力性气颅病例。尽管可利用鼻内镜鼻窦手术修复缺损，但筛骨骨片颅内移位使得开放手术入路更为可行。他的术后病程平稳，术后CT扫描未显示气颅迹象。无脑脊液漏使得该病例在表现上独具特点，并导致诊断延迟。鼻中隔成形术后出现严重头痛应提醒外科医生调查可能的颅内并发症。
