Our Summary

This research paper discusses a case where a patient developed a severe headache due to a condition called tension pneumocephalus two days after a nose surgery (septoplasty). Tension pneumocephalus is a rare condition where air gets trapped in the brain causing pressure. Usually, this condition is treated with sinus surgery or an open approach to fix the defect that allowed the air in. However, in this case, the patient’s condition improved on its own with simple, non-invasive treatments like bed rest and keeping the head elevated. The patient was kept under observation and scans done 3 and 8 months after he was discharged showed no signs of the condition. The paper suggests that in cases of severe headaches after nose surgery, doctors should evaluate for possible complications inside the brain. Before resorting to surgery, simple treatments should be tried and the patient should be regularly checked.

FAQs

  1. What is tension pneumocephalus and how can it occur after a septoplasty surgery?
  2. What are the treatment options for pneumocephalus following septoplasty?
  3. What are the necessary follow-up procedures after treatment for pneumocephalus post-septoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about septoplasty is to follow post-operative care instructions closely, including taking any prescribed medications, avoiding strenuous activities, and keeping the head elevated to reduce swelling. It is important to contact your doctor if you experience severe headaches or any other concerning symptoms after the surgery. Regular follow-up appointments are also recommended to ensure proper healing and to address any potential complications.

Suitable For

Patients who are typically recommended for septoplasty are those who have a deviated septum causing symptoms such as difficulty breathing, recurrent sinus infections, snoring, and nasal obstruction. Septoplasty can also be recommended for patients with nasal trauma or deformities that affect the nasal airway. Additionally, patients with chronic sinusitis or nasal polyps may benefit from septoplasty in conjunction with other sinus surgeries. It is important for patients to consult with an otolaryngologist to determine if septoplasty is the appropriate treatment option for their specific condition.

Timeline

Before septoplasty:

  • Patient experiences symptoms such as difficulty breathing through the nose, frequent nosebleeds, sinus infections, and snoring.
  • Patient consults with an otolaryngologist who recommends septoplasty to correct a deviated septum.
  • Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.

After septoplasty:

  • Patient undergoes septoplasty surgery to straighten the septum and improve nasal airflow.
  • Patient may experience mild pain, swelling, and nasal congestion in the days following surgery.
  • 2 days after surgery, patient develops a severe headache and is diagnosed with tension pneumocephalus.
  • Patient receives conservative treatment with bed rest and head elevation to manage the pneumocephalus.
  • Patient undergoes regular follow-up examinations to monitor their progress and ensure no further complications arise.
  • 3rd and 8th months after discharge, patient’s examinations are uneventful and CT scan shows no signs of pneumocephalus.
  • Patient experiences improved nasal airflow and reduced symptoms such as snoring and sinus infections.

What to Ask Your Doctor

  1. What are the potential risks and complications of septoplasty surgery, including the risk of developing tension pneumocephalus?
  2. How common is tension pneumocephalus after septoplasty surgery?
  3. What are the symptoms of tension pneumocephalus that I should be aware of post-surgery?
  4. How is tension pneumocephalus typically diagnosed and treated?
  5. What are the steps to take if I experience severe headaches or other concerning symptoms after septoplasty surgery?
  6. How will my recovery process be monitored to ensure that any complications, such as tension pneumocephalus, are promptly identified and addressed?
  7. Are there any specific factors or conditions that may increase my risk of developing tension pneumocephalus after septoplasty surgery?
  8. What measures can I take to reduce my risk of developing tension pneumocephalus or other complications during the recovery period?
  9. How long should I expect the recovery period to last, and when should I seek medical attention if I have concerns about my healing progress?
  10. Are there any alternative treatments or surgical approaches that could reduce the risk of complications, such as tension pneumocephalus, during or after septoplasty surgery?

Reference

Authors: Çiçek MT, Tan M. Journal: J Craniofac Surg. 2021 May 1;32(3):e283-e284. doi: 10.1097/SCS.0000000000007186. PMID: 33534302