Postoperative complication of endoscopic nasopharyngeal multiple cysts resection with skull base osteomyelitis: Case report.

RATIONALE

Osteomyelitis of the skull following the endoscopic resection of multiple nasopharyngeal cysts is extremely rare. Postoperative headache, in the absence of fever or ear pain, may no be typically present and could be easily overlooked, potentially leading to a delay in diagnosis and treatment.

PATIENT CONCERNS

In this case report, we present the case of a 57-year-old male patient who developed persistent headache symptoms 1 week after undergoing endoscopic resection of nasopharyngeal cysts under general anesthesia and was diagnosed with skull base osteomyelitis (SBO).

DIAGNOSES

SBO.

INTERVENTIONS

After the diagnosis of SBO, the patient was treated with a full course of antibiotics, including 2.0 g ceftriaxone for intravenous infusion for 1 week, 2.5 g of piperacillin sodium and sulbactam for intravenous infusion 12 hours for 2 weeks, and 0.6 g of linezolid tablets for oral administration twice a day for 2 weeks. Under local conditions, endoscopic nasopharyngeal incision and drainage were performed, during which necrotic tissue and pus were removed, and deep tissue secretions were taken.

OUTCOMES

In the follow-up 6 months at the outpatient clinic after discharge, the patient's headache improved, no complications occurred, and no symptoms of cranial nerve palsy were observed.

LESSONS

Magnetic resonance imaging revealed 3 deep cysts in the nasopharynx. During surgery, when using plasma to resect cysts, it is necessary to avoid excessive exposure or damage to the bone, which would increase the risk of postoperative SBO.