Image-guided Functional Endoscopic Sinus Surgery Complicated with Pneumocephalus

影像導引之功能性內視鏡鼻竇手術併發氣腦

江榮山(Rong-San Jiang)

《台灣耳鼻喉頭頸外科雜誌》 49卷3期 (2014/09) Pp. 192-196

https://doi.org/10.6286/2014.49.3.192

摘要

影像導引手術在過去二十年在功能性內視鏡鼻竇手術上已漸漸扮演重要且更廣泛的角色但它是否能減少功能性內視鏡鼻竇手術併發症的發生或提高手術的成功率尚未有定論。而氣腦是功能性內視鏡鼻竇手術少見的顱內併發症。本病例報告1名病患因慢性鼻及鼻竇炎合併鼻息內接受左側影像導引之功能性內視鏡鼻竇手術。手術過程順利但術後4日病患覺得全身無力及語言不清回到本院急診，腦部電腦斷層檢查發現氣腦。病患經住院接受保守治療後追蹤半年並無其它併發症。雖然影像導引之功能性內視鏡鼻竇手術已漸廣為運用但其仍可能引發嚴重併發

關鍵字

慢性鼻及鼻竇炎 ； 併發症 ； 功能性內視鏡鼻竇手術 ； 影像導引手術 ； 氣腦

並列摘要

Image-guided surgery has played an important and expanding role in functional endoscopic sinus surgery (FESS) over the past two decades. Its impact on complications and clinical outcomes of FESS remains unclear. On the other hand, pneumocephalus is a very rare intracranial complication of FESS. We present a patient who underwent imaged-guided FESS under the impression of left chronic rhinosinusitis with nasal polyps. The operative course was uneventful. However, he felt weak and his speech became slurred 4 days after surgery, so he came to our emergency department. A brain CT revealed large pneumocephalus. The patient was admitted for conservative treatment and was asymptomatic half a year after surgery. Although Image-guided surgery has been widely used in FESS, major complications still occurred.

並列關鍵字

chronic rhinosinusitis ； complication ； functional endoscopic sinus surgery ； image-guided surgery ； pneumocephalus