Wolter Gabrielle, Naqvi Zain U, Jalali Ali, Locke Tran, Gallagher K Kelly, Fox Meha G
Department of Otolaryngology, Baylor College of Medicine, Houston, USA.
School of Medicine, Baylor College of Medicine, Houston, USA.
Cureus. 2025 Jul 30;17(7):e89085. doi: 10.7759/cureus.89085. eCollection 2025 Jul.
Inadvertent intracranial nasogastric tube placement is a recognized risk following skull base fracture, but prior skull base surgery also poses a significant and underrecognized risk for this potentially fatal complication. We report the case of a 75-year-old female admitted with colitis, six months after endoscopic endonasal resection of a pituitary macroadenoma. A systematic review identified 10 prior cases of intracranial tube placement following skull base or sinonasal surgery, including nasotracheal and feeding tube insertions. Literature suggests that using small-bore flexible tubes and preserving anatomical barriers, such as the position of the middle turbinate and intact bony structures like the sphenoid sinus roof, may reduce risk. We aim to characterize the risk of iatrogenic intracranial tube placement through a systematic review and a representative case.
颅底骨折后，意外将鼻胃管置入颅内是一种公认的风险，但既往颅底手术也会给这种潜在致命并发症带来重大且未被充分认识的风险。我们报告了一例75岁女性患者，该患者在内镜下经鼻切除垂体大腺瘤六个月后因结肠炎入院。一项系统评价确定了10例既往在颅底或鼻窦手术后发生颅内置管的病例，包括鼻气管插管和饲管插入。文献表明，使用细径柔性管并保留解剖屏障，如中鼻甲的位置和蝶窦顶等完整的骨质结构，可能会降低风险。我们旨在通过系统评价和一个典型病例来描述医源性颅内置管的风险。
