Missed skull base injury during sinonasal surgery: A dangerous scenario still existing

Skull base injury is a known complication of sinonasal surgery. Cerebrospinal fluid (CSF) rhinorrhea has been reported to occur in 0 to 2.5% of these procedures. More extensive skull base injury may result in more serious complications. In this retrospective case series, we report on 7 cases of iatr...

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Bibliographic Details
Published in:Ear, nose, & throat journal nose, & throat journal, 2015-08, Vol.94 (8), p.E37-E42
Main Authors: Hassab, Mohamed H, Eweiss, Ahmed Z, Ibrahim, Ahmed A
Format: Article
Language:English
Subjects:
Adult
Cerebrospinal Fluid Rhinorrhea - etiology
Endoscopy - adverse effects
Endoscopy - methods
Exotropia - etiology
Female
Humans
Male
Meningitis - etiology
Middle Aged
Orbit - injuries
Paranasal Sinuses - surgery
Postoperative Complications - diagnostic imaging
Recurrence
Retrospective Studies
Skull Base - diagnostic imaging
Skull Base - injuries
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Summary:Skull base injury is a known complication of sinonasal surgery. Cerebrospinal fluid (CSF) rhinorrhea has been reported to occur in 0 to 2.5% of these procedures. More extensive skull base injury may result in more serious complications. In this retrospective case series, we report on 7 cases of iatrogenic skull base injury due to sinonasal surgery that was missed by the operating surgeons. Included were 5 male and 2 female patients. Six patients sustained the skull base injury during endoscopic sinus surgery, and 1 patient was injured during septoplasty. Two patients presented with CSF rhinorrhea alone, 2 patients had repeated episodes of meningitis, 2 patients had other neurologic sequelae, and 1 patient had exotropia due to associated orbital injury. We conclude that skull base injury due to sinonasal surgery is still being missed; this oversight may lead to potentially fatal results. The true incidence of this complication is probably still unknown.
ISSN:1942-7522