ABDÜLKADİR İMRE, ERCAN PINAR, Ahmet Ata ECE

Ethmoidal meningoencephalocele and cerebrospinal fluid leak after septoplasty: a rare complication

Yirmi dört yafl>nda erkek hasta aral>klarla olan sa¤ tarafl> su gibi burun ak>nt>s> flikayeti ile klini¤imize refere edildi. Hasta 1 y>l önce septoplasti operasyonu olmufl ve operasyondan 2 hafta sonra rinore ortaya ç>km>fl- t>r. Rinore flikayeti ihmal edilen hastada ameliyattan 2 ay sonra da menenjit geliflmifltir. Bunu takiben de meningoensefalosel formasyonu oluflmufltur. Bu olgu sunumunda, septoplasti operasyonundan bir y>l sonra tan> konan meningoensefalosel ve efllik eden serebrospinal s>v> ka- ça¤> olgusunu sunduk. Septoplasti genellikle güvenli bir operasyon olarak kabul edilmektedir. Bununla birlikte, etmoid kemi¤in perpendiküler laminas>na zorlay>c> kuvvetli manevralar uygulanmas> kafa kaidesi yap>- lar>nda özellikle de kribriform plakan>n horizontal laminas>nda fraktüre neden olabilmektedir. Böyle bir durumda, menenjit, intrakraniyal apse ve pnömosefalus gibi intrakraniyal komplikasyonlar>n geliflmesini önlemek için hemen tamir edilmesi gerekmektedir. Böyle bir hasarda tan>da gecikme kafa kaidesindeki kemikte erozyona ve zamanla bu defektten intrakraniyal içeri¤in herniye olmasIna neden olabilmektedir.

Septoplasti sonrasında etmoidal meningoensefaloselve serebrospinal sıvı kaçağı: Nadir görülen bir septoplastikomplikasyonu

A 24-year-old man referred to our clinic with complaint of intermittent right-sided watery rhinorrhea. Patient underwent nasal septoplasty one year ago and rhinorrhea occurred two weeks after the surgery. Rhinorrhea was ignored and then patient developed meningitistwo months after the surgery. Subsequently, meningoencephaloceleformation developed. In this case report, we present a case of meningoencephalocele associated with cerebrospinal fluid leak diagnosedone year after the septoplasty. Septoplasty is usually regarded as a relatively safe operation. However, forceful maneuvers to perpendicularlamina of the ethmoid bone may cause breakdown of the skull basestructures, particularly the horizontal lamella of the cribriform plate.When this occur, immediate management is necessary to preventintracranial complications including meningitis, intracranial abscess,and pneumocephalus. Delay in the diagnosis of such injury may causeerosion of the bone and gradual herniation of the intracranial contents through the skull base defect.

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