頸部穿刺傷遺留的顱底異物－病例報告

Skull Base Foreign Body Following Cervical Penetrating Injury - Case Report

陳加偉(Chia-Wei Chen) ； 辛宗翰(Chung-Han Hsin) ； 歐哲甫(Che-Fu Ou) ； 蘇茂昌(Mao-Chang Su) ； 劉乃文(Nai-Wen Liu)

《中華民國耳鼻喉科醫學雜誌》 37卷2期 (2002/03) Pp. 156-158

https://doi.org/10.6286/2002.37.2.156

摘要

顱底鄰近重要的血管及神經，發生於此的穿刺傷，其危險性相當大，宜對於有頸部穿刺傷的患者，日後可能有異物留置體內導致相關症狀的可能性加以注意。本病例報告為一21歲男性，主訴牙關緊閉已有十多年，回顧其病史，十多年前因爭執被其兄以筷子從頸部刺入。筷子折斷，求診於當地醫院，經包紮傷口後離院，此後即有牙關緊閉的現象。來本院就診時，纖維內視鏡檢查發現一筷子斜置於鼻咽腔，兩端沒入鼻咽兩側側壁，電腦斷層顯示此異物已深達顱底。於是住院接受手術治療，以鼻竇內視鏡方式從鼻內進入，截斷異物後取出，術後恢復良好。

關鍵字

異物 ； 穿刺傷 ； 顱底

並列摘要

The nasopharynx is adjacent to the skull base and penetrating injuries of this area can be quite serious, owing to its proximity to great vessels and nerves. A thorough examination of patients with a history of penetrating neck trauma must be made to exclude the possibility of foreign body retention in this area. This case study describes a 21 year old male with a ten year history of trismus. A detailed history revealed that the patient had suffered a penetrating neck injury with a chopstick during a fight some 11 years earlier. The patient had received medical attention shortly after the injury and since no foreign body was visible, the wound was cleaned and dressed at that time. The patient exhibited trismus following the injury and his symptoms gradually worsened. During a visit to our out-patient clinic, a fiberoptic endoscopy was performed which showed a broken chopstick within the nasopharynx. The foreign body was positioned horizontally with each end embedded in a lateral wall. A CT scan showed that the foreign body had penetrated deeply into the skull base. The patient was hospitalized and the foreign body was divided and removed during an endoscopic nasopharyngeal surgical procedure. The patient did very well post-operatively.

並列關鍵字

foreign body ； penetrating injury ； skull base