An unusual complication of functional endoscopic sinus surgery: subarachnoid hemorrhage

Abstract

Over the past decade, endoscopic sinus surgery has become one of the most frequently performed operations in otolaryngology. Several intracranial, orbital and intranasal complications have been described. Major complications include cerebrospinal rhinorrhea, cribriform plate injuries, frontal lobe injuries and blindness. These are extremely rare and represent a very small percentage of total complications. We present an unusual case of a 33-year-old white man who underwent functional sinus surgery in another clinic. During the endoscopic sinus surgery dura trauma occurred but was repaired. In the early postoperative period urgent computed tomography was undertaken as the paresis took place at the lower extremities. It was observed that he had subarachnoid hemorrhage due to the injury to anterior cerebral artery, and cerebrospinal fluid fistula with subsequent meningitis. The patient was given general anesthesia for the repair of cerebrospinal fluid fistula when he recovered. The patient was discharged at the 6th postoperative day. His 8th month follow-up revealed full recovery in his lower extremities.

Keywords

• fess complication
• anterior cerebral artery hemorrhage
• subarachnoid hemorrhage
• cerebrospinal fistula
• meningitis