Meningoencephalitis Following Endoscopic Dacryocystorhinostomy

Area of Science:

• Otolaryngology
• Neurosurgery
• Infectious Disease

Background:

• Endonasal dacryocystorhinostomy is a common surgical procedure for nasolacrimal duct obstruction.
• Complications, though rare, can be severe and require prompt recognition.

Observation:

• An 81-year-old male developed severe headache and rigors two days after endonasal DCR.
• Imaging revealed an anterior cranial fossa floor defect and adjacent meningoencephalitis.
• The patient presented with febrile septic symptoms post-operatively.

Findings:

• The study reports the first known case of meningoencephalitis following endonasal DCR.
• Cranial fossa floor defect was suspected to be iatrogenically caused during surgery.
• Intravenous antibiotic therapy resulted in complete patient recovery without sequelae.

Implications:

• Meningoencephalitis should be considered in patients presenting with headache or febrile illness after endonasal DCR.
• Early diagnosis and treatment are crucial for favorable outcomes.
• This case highlights the importance of meticulous surgical technique in endonasal procedures.