title: Missed skull base injury during sinonasal surgery: A dangerous scenario still existing.
abstract: 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.
authors: Department of Otolaryngology, Faculty of Medicine, University of Alexandria, Egypt.
authors: Mohamed H
authors: MH
authors: Hassab
authors: Ahmed Z
authors: AZ
authors: Eweiss
authors: Ahmed A
authors: AA
authors: Ibrahim
mesh_terms: D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D005099:Exotropia / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology; D008875:Middle Aged; D009915:Orbit / Q000293:injuries; D010256:Paranasal Sinuses / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012008:Recurrence; D012189:Retrospective Studies; D019291:Skull Base / Q000000981:diagnostic imaging / Q000293:injuries*