Septal hematoma after balloon dilation of the sphenoid.

نویسندگان

  • Alan A Z Alexander
  • David C Shonka
  • Spencer C Payne
چکیده

When medical management of chronic rhinosinusitis fails to achieve benefit, surgery is often recommended. Functional endoscopic sinus surgery (FESS) has become the method of choice for addressing this disease, and advances in instrumentation to facilitate FESS have led to significant advances and outcome improvements. More recently, balloon dilation of the sinus ostia (BDSO) using balloon sinuplasty instruments (Acclarent, Menlo Park, CA) has been introduced in an attempt to enhance mucosal preservation, decrease local trauma, and provide an effective means of relieving disease without the risks of more aggressive measures. Initial cadaveric studies revealed this method, which is successful in remodeling bone and tissue in the area of the sinus transition spaces. Thus far there have been no reported cases of significant postoperative complications directly attributable to the use of the balloon. This case report was approved by the Institutional Review Board for Health Science Research at the University of Virginia. A 51-year-old female was referred to the University of Virginia with complaints of chronic headache and recurrent episodes of rhinosinusitis. Multiple courses of antibiotics, saline irrigations, and intranasal steroids failed to improve her symptoms. Computed tomography of the sinuses demonstrated isolated, near-total opacification of bilateral sphenoid sinuses with adjacent osteitis. Her past medical history was notable for coronary artery disease with prior bypass grafting and Factor V Leiden disorder requiring warfarin therapy. Given the patient’s anticoagulation, the decision was made to pursue BDSO of the sphenoid. This was expected to minimize the risk of blood loss. At surgery, the patient’s INR was normal and 12 hours had passed since her last dose of Lovenox. Intraoperatively, the left sphenoid ostium was identified and BDSO performed (Fig 1). This was then repeated on the right side. Reexamination of the left side was then notable

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عنوان ژورنال:
  • Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

دوره 141 3  شماره 

صفحات  -

تاریخ انتشار 2009