Meningoencephalitis Following Endoscopic Dacryocystorhinostomy

Abstract

An 81-year-old man with unilateral nasolacrimal duct obstruction underwent routine endonasal dacryocystorhinostomy and 2 days postoperatively developed a severe headache and rigors. Subsequent CT and MRI imaging demonstrated a defect in the floor of the right anterior cranial fossa, which possibly was damaged during the operation, and meningoencephalitis of the adjacent frontal lobe gyrus. Following intravenous antibiotic treatment, the patient made a full recovery with no ongoing sequelae, and his epiphora completely resolved. To the authors' knowledge, this is the first report of meningoencephalitis following endonasal dacryocystorhinostomy. This complication should be considered in any patient with a febrile septic presentation or headache following endonasal dacryocystorhinostomy.

Delayed unilateral pneumocephalus after bilateral endoscopic dacryocystorhinostomy in an elderly patient

“…The most recent case was reported by Cheong and Davies. 4 The 81-year-old man developed meningoencephalitis after endoscopic DCR for unilateral NLDO. Two days postoperatively, he reported of a severe right-sided headache.…”

“…Both pneumocephalus and meningitis are relatively rare complications of this procedure. There are only three published case reports of meningitis secondary to external DCR, [2][3][4] and there are no published case reports of pneumocephalus secondary to endoscopic DCR. We present the first case report of delayed unilateral pneumocephalus after bilateral endoscopic DCR.…”