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Tension pneumocranium post FESS - perforation of ethmoidal air cells

Case contributed by Dr Chris O'Donnell

Presentation

Headache and neck stiffness post FESS for inflammatory paranasal sinus disease

Patient Data

Age: 60
Gender: Male

Gross pneumocranium post functional endoscopic sinus surgery (FESS) for chronic paranasal sinus inflammatory disease. Defect in the roof of the right anterior ethmoidal aircells with a fistula into the subarachnoid space indicating disruption to the dura. Gas has thus passed from the nasal cavity into the cranium via the ethmoidal aircells. Note the compression of this gas on the frontal lobes (arrows). This indicates mass effect and suggests that the gas (air) is under tension.

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Case information

rID: 30922
Published: 9th Sep 2014
Last edited: 12th Oct 2020
System: Head & Neck
Inclusion in quiz mode: Included

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