RESUMO
A 47-year-old woman presented with a left-sided watery nasal discharge persisting for 3 weeks after an orthopedic operation using spinal anesthesia. The testing of the nasal fluid for ß-2 transferrin confirmed that the leakage was cerebrospinal fluid (CSF). The computed tomographic cisternography revealed a left-sided bone defect in the cribriform plate. Endonasal approach was performed for closing the defect. At 3-month follow-up, CSF rhinorrhea had not recurred. In this report, we present an unexpected CSF rhinorrhea after a spinal anesthesia and discuss the reason of spontaneous leak after spinal anesthesia, as well as discuss current diagnosis and management of CSF rhinorrhea with the composite graft.
Assuntos
Raquianestesia/efeitos adversos , Rinorreia de Líquido Cefalorraquidiano/etiologia , Doenças Ósseas/cirurgia , Transplante Ósseo/métodos , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Endoscopia , Osso Etmoide/cirurgia , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Seguimentos , Humanos , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Adesivos Teciduais/uso terapêutico , Tomografia Computadorizada por Raios X , Transferrina/análise , Conchas Nasais/cirurgiaRESUMO
Actinomycosis of the tongue is uncommon, but without proper treatment, it causes extensive tissue destruction. A mass that may mimic both benign and malignant neoplasms can be seen at clinical presentation and may mislead the diagnosis. Early diagnosis is critical but usually difficult with cultures or imaging. We report a patient who presented with a tumor-like deeply localized primary actinomycosis of the tongue with its magnetic resonance imaging findings.