Severe complication of posterior nasal packing: Case Report

Summary

Introduction: Severe Epistaxis is common in patients with head trauma, especially when associated with multiple fractures of the face and skull base. Several methods of controlling bleeding that can be imposed. The anterior nasal tapenade associated with posterior Foley catheter is one of the most widespread, and the universal availability of necessary materials or their apparent ease of execution.

Methods: Case report on control of severe epistaxis after severe TBI, with posterior nasal packing by Foley catheter and control tomography showing multiple fractures of the skull base and penetration of the probe into the brain parenchyma.

Conclusion: This is a rare but possible complication in the treatment of severe nose bleeds associated with fracture of the skull base. This brief report highlights risks related to the method and suggests some care to prevent complications related through a brief literature review.

Keywords

epistaxis - fracture of the skull base - Craniocerebral Trauma

• References

• 1 Hartley C, , FRKD, Axon PR. , MB, BS. The Foley catheter in epistaxis management - a scientific appraisal. Journal of Laryngology and Otology 1994; 108: 399-402
• 2 Lee WC, Ku PKM, Hasselt CA. Foley Catheter Action in the Nasopharynx. Arch Otolaryngol Head Neck Surg 2000; 126: 1130-1134
• 3 Pawar SJ, Sharma RR, Lad SD. Intracranial migration of Foley catheter - an unusual complication. Journal of Clinical Neuroscience 2003; 10 (2) 248-249
• 4 Woo HJ, Bai CH, Song SY, Kim YD. Intracranial placement of a Foley catheter: A rare complication. Otolaryngology-Head and Neck Surgery 2008; 138: 115-116
• 5 Blasco V, Heng Ban L, Velly L, Leone M, Gouin F. Brain placement of a duble balloon catheter after extensive craniofacial trauma. Annales Françaises d́Anesthésie et de Réanimation 2008; 27: 843-845
• 6 Arslantas A, Durmaz R, Cosan E, Tel E. Inadvertent insertion of a nasogatric tube in a patient with head trauma. Child's Nerv Syst 2001; 17: 112-114
• 7 Pandey AK, Sharma Ak, Diyora BD, Sayal PP, Ingale HA, Radharkrishnan M. Inadvertent Insertion of Nasogastric Tube into the Brain. JAPI 2004; 52: 322-333
• 8 Genú PR , et al. Inadvertent Intracranial Placement of a Nasogastric Tube in a Patient With Severe Craniofacial Trauma: A Case Report. J Oral Maxillofac Surg 2004; 62: 1435-1438