Meningoencephalocele formation after nasal septoplasty and management of this complication.
OBJECTIVE
Patients undergoing nasal septoplasty can face many complications. Some of these complications are rare but their results are life threatening. Being aware of this complication could prevent further problems such as enlargement of the bone and dural defect, herniation of the meninges and brain tissue through the defect by pulsation of the brain and ascending infection. With early diagnosis, a less aggressive method could be used to treat this complication.


METHODS
A 50-year-old woman was admitted our hospital with the complaint of loss of consciousness. Her Glasgow coma score was 7 on admission. She had no lateralizing signs, but had nuchal rigidity. Blood pressure was 200/110mm Hg, the respiratory pattern was apneic, complete blood count revealed 12000 leucocytes/mm3 and arterial blood gases showed respiratory acidosis and other biochemical parameters were within normal limits. Computerized cranial tomography (CCT) showed diffuse brain edema without evidence of other signs. Lumbar puncture was performed revealing purulent and highly viscous cerebrospinal fluid (CSF).


CONCLUSIONS
Late diagnosis and late repair of arachnoidodural tearing could lead to life-threatening complications, and cases with meningitis and larger defects may require more extensive surgery instead of transnasal endoscopic repair.
Gülşen
Salih
S
Baskent University, Department of Neurosurgery, Ankara, Turkey. salihgulsen07@gmail.com
Yilmaz
Cem
C
Aydin
Erdinç
E
Koçbiyik
Alper
A
Altinörs
Nur
N
D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000473:pathology / Q000628:therapy; D004677:Encephalocele / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008588:Meningocele / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology / Q000628:therapy*; D012225:Rhinoplasty / Q000009:adverse effects*