Two consecutive cases of cerebrospinal fluid rhinorrhea after septoplasty operation

Önerci, T. Metin; Ayhan, Keramettin; Öǧretmenoǧlu, Oğuz

doi:10.1016/j.amjoto.2004.03.005

Cited by 48 publications

(35 citation statements)

References 4 publications

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“…They are generally well-tolerated procedures, with excellent patient results, with one study reporting clinical improvement in up to 98% of patients. 1 Although several common complications exist, including cosmetic defects, bleeding, anosmia, infection, and septal perforation, [2][3][4][5] life-threatening complications are extremely rare, with death resulting in only 0 -0.1% of cases 2 and defined for the most part only in case reports. 4 In general, OHNS divide complications of these surgeries into major and minor complications.…”

Section: Discussionmentioning

confidence: 99%

Death Related to Nasal Surgery

Tawadros

Prahlow²

2008

American Journal of Forensic Medicine &Amp; Pathology

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The investigation of deaths that are suspected to be related to medical therapy present several challenges for the forensic pathologist. In all such cases, it is important for the pathologist to understand the therapy/procedure that may have played a role in death. As such, review of medical records and possible consultation with various medical specialists before autopsy can provide valuable information to ensure proper evaluation in any given case.Herein, we describe a rare death occurring as a complication of septoplasty, nasal polypectomy, and intranasal endoscopic ethmoidectomy, which are common surgical procedures performed by otolaryngology/head and neck surgeons. An otherwise healthy 58-year-old woman underwent the elective surgical procedures for a deviated nasal septum, multiple nasal polyps, and chronic ethmoid sinusitis. Following surgery, the patient never awoke from general anesthesia, and further evaluation before death revealed a basilar subarachnoid hemorrhage. Autopsy disclosed basilar subarachnoid hemorrhage, a traumatic defect of the right cribiform plate, and associated anterior cerebral artery injury with frontal lobe damage. No vascular anomalies were present. The cause of death was attributed to complications related to nasal surgery, and the manner of death was ruled "accident."Following the presentation of this case, the authors discuss these common nasal surgical procedures, including a summary of their known complications. In addition, the authors address and review the topic of deaths related to medical therapy.

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Section: Discussionmentioning

confidence: 99%

Death Related to Nasal Surgery

Tawadros

Prahlow²

2008

American Journal of Forensic Medicine &Amp; Pathology

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“…the junction between the cribriform plate and the ethmoid labyrinth, where the bone is quite thin and the dura is tightly adherent (11). CSF leakage after septoplasty might occur when septal mucoperichondrial elevation is performed beyond the ethmoid roof or perpendicular lamina is fractured, which may cause fracture of the cribriform plate (12). Iatrogenic trauma to the frontal and sphenoid sinuses is more likely to occur due to endoscopic sinus surgery rather than septoplasty (13).…”

Section: Discussionmentioning

confidence: 99%

Sphenoid Sinus Injury Leading Pneumocephalus as a Complication of Conventional Septoplasty

Günaydın¹,

Özer²,

Süslü³

et al. 2014

Turk Arch Otolaryngol

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“…A few authors have reported CSF leakage after septoplasty. [3,7,8] They proposed that these slit-shaped dehiscences at the horizontal lamella of the cribriform plate or perforation of the cribriform plate likely resulted from forceful operative technique applied for removal of the perpendicular plate of the ethmoid bone.…”

Section: Discussionmentioning

confidence: 99%

“…However, various complications including CSF leak following septoplasty are reported previously. [3,4] Meningoencephalocele formation associated with CSF leak following septoplasty is very rare. [5] In this case report, we present a case of meningoencephalocele associated with CSF leak diagnosed one year after nasal surgery.…”

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confidence: 99%

Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication

İmre¹,

Pınar²,

Ece³

2017

ENT Updates

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Meningoencephalocele and cerebrospinal fluid (CSF) rhinorrhea of the anterior cranial fossa is a well known entity resulting from iatrogenic and non-iatrogenic causes including congenital malformations and skull base erosion from intracranial tumors. Iatrogenic CSF leaks frequently occur during endonasal transsphenoidal pituitary surgery and functional endoscopic sinus surgery. [1,2] Septoplasty, one of the most common operations performed in otolaryngology, is usually regarded as a relatively safe operation. However, various complications including CSF leak following septoplasty are reported previously. [3,4] Meningoencephalocele formation associated with CSF leak following septoplasty is very rare. [5] In this case report, we present a case of meningoencephalocele associated with CSF leak diagnosed one year after nasal surgery. The probable pathological mechanism and endonasal endoscopic management of this complication were discussed. Özet: Septoplasti sonras›nda etmoidal meningoensefalosel ve serebrospinal s›v› kaça¤›: Nadir görülen bir septoplasti komplikasyonuYirmi dört yafl›nda erkek hasta aral›klarla olan sa¤ tarafl› su gibi burun ak›nt›s› flikayeti ile klini¤imize refere edildi. Hasta 1 y›l önce septoplasti operasyonu olmufl ve operasyondan 2 hafta sonra rinore ortaya ç›km›fl-t›r. Rinore flikayeti ihmal edilen hastada ameliyattan 2 ay sonra da menenjit geliflmifltir. Bunu takiben de meningoensefalosel formasyonu oluflmufltur. Bu olgu sunumunda, septoplasti operasyonundan bir y›l sonra tan› konan meningoensefalosel ve efllik eden serebrospinal s›v› kaça¤› olgusunu sunduk. Septoplasti genellikle güvenli bir operasyon olarak kabul edilmektedir. Bununla birlikte, etmoid kemi¤in perpendiküler laminas›na zorlay›c› kuvvetli manevralar uygulanmas› kafa kaidesi yap›-lar›nda özellikle de kribriform plakan›n horizontal laminas›nda fraktüre neden olabilmektedir. Böyle bir durumda, menenjit, intrakraniyal apse ve pnömosefalus gibi intrakraniyal komplikasyonlar›n geliflmesini önle-mek için hemen tamir edilmesi gerekmektedir. Böyle bir hasarda tan›da gecikme kafa kaidesindeki kemikte erozyona ve zamanla bu defektten intrakraniyal içeri¤in herniye olmas›na neden olabilmektedir.Anahtar sözcükler: Endoskopik onar›m, komplikasyon, meningoensefalosel, septoplasti, serebrospinal s›v› kaça¤›. AbstractA 24-year-old man referred to our clinic with complaint of intermittent right-sided watery rhinorrhea. Patient underwent nasal septoplasty one year ago and rhinorrhea occurred two weeks after the surgery. Rhinorrhea was ignored and then patient developed meningitis two months after the surgery. Subsequently, meningoencephalocele formation developed. In this case report, we present a case of meningoencephalocele associated with cerebrospinal fluid leak diagnosed one year after the septoplasty. Septoplasty is usually regarded as a relatively safe operation. However, forceful maneuvers to perpendicular lamina of the ethmoid bone may cause breakdown of the skull base structures, particularly the horizontal lamella of the cribriform p...

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Two consecutive cases of cerebrospinal fluid rhinorrhea after septoplasty operation

Cited by 48 publications

References 4 publications

Death Related to Nasal Surgery

Death Related to Nasal Surgery

Sphenoid Sinus Injury Leading Pneumocephalus as a Complication of Conventional Septoplasty

Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication

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