Traumatic transnasal penetrating injury with cerebral spinal fluid leak

EXCLI Journal

Sethu Thakachy Subha¹  Tan Sui Teng²  Noor Liza Ishak³ 

[1] Department of Otorhinolaryngology, Head and Neck Surgery, Serdang Hospital, Jalan Puchong, Kajang, Selangor Darul Ehsan, 43000 Malaysia;Department of Otorhinolaryngology, Head and Neck Surgery, Serdang Hospital, Jalan Puchong, Kajang, Selangor Darul Ehsan, 43000 Malaysia, Tel: [phone], Fax : [phone], E-mail: [e-mail];Ear, Nose and Throat Unit, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

关键词: pencil;    penetrating trauma;    skull base fracture;    CSF leak;   

DOI  :  10.17179/excli2018-1971

学科分类：过敏症与临床免疫学

来源: University of Mainz, University of Leipzig

【 摘 要 】

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.

【 授权许可】

CC BY