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후사골동 점액낭종에 대한 비내시경적 조대술 이후 발생한 뇌척수액 비루 및 세균성 뇌막염 증례
황윤석(Yoonseok Hwang),장태영(Tae Young Jang),김영효(Young Hyo Kim) 대한두개저학회 2014 대한두개저학회지 Vol.9 No.1
A 52-year-old female patient suffered from left visual disturbance and nasal obstruction for a week. Through physical examination using rigid endoscopy and computed tomography, we could diagnose the paranasal sinus mucocele arising from left onodi cell, compressing the left optic nerve. Endoscopic marsupialization was performed immediately and the next day of the operation, her left visual acuity was recovered to 0.8. Ten days after surgery, she complained headache and fever. Nasal endoscopy showed pulsatile leakage of clear fluid from posterior ethmoid roof. The chemistry of fluid suggested cerebrospinal fluid(CSF) and the computed tomography showed bony defect of posterior ethmoid roof. Defect of skull base was successfully repaired by the fascia lata. However, the patient suffered from fever and severe headache due to bacterial meningitis caused by methicillin-resistant staphylococcus aureus, which was cured by 2 weeks of vancomycin administration.