부비동 내시경수술 후 발생한 기뇌증과 심각한 뇌수막염 치험 1예

Pneumocephalus represents rare complications in endoscopic sinus surgery. Pneumocephalus following nasal and sinus surgery occurs because of iatrogenic damage to the skull base. Patients with posttraumatic cerebrospinal fluid leakage lasting more than 7 days have at least 8- to 10-fold increase in risk of meningitis. Although treatment regimens for Streptococcus pneumoniae meningitis have improved, the mortality rate remains as high as 25% with neurological sequelae in up to half of survivors. We report a 35-year-old man with pneumocephalus and meningitis as complications of endoscopic sinus surgery. We initially treated the patient by administration of antibiotics and lumbar drain. After controlling inflammation, endoscopic repair of cerebrospinal fluidrhinorrhea with osteomucoperiosteal free flap obtained from the middle turbinate under general anesthesia was done. The patient was followed up without any complication. (J Clinical Otolaryngol 2011;22:243-246)