臨床
口蓋癌術後に生じた頸動脈海綿静脈洞瘻例
2018 年 111 巻 12 号 p. 821-827
詳細
2018 年 111 巻 12 号 p. 821-827
Objective: We report a case of carotid-cavernous sinus fistula (CCF) occurring as a complication of surgery for palate cancer.
Findings: A 64-year-old man presented to us with palate cancer. We performed bilateral neck dissection, resection of the palate cancer, and reconstruction using a left forearm flap. On the day after the surgery, the patient developed chemosis, ptosis, dilatation of the pupil, and ocular motility disorder in his right eye. On the basis of the findings of head MRI, MRA and cerebral angiography, we made the diagnosis of CCF. We occluded the fistula by endovascular embolization with coils. While the chemosis began to improve gradually, the other symptoms remained. At 14 months after the first operation, strabismus surgery was performed. Ever since the surgery until date, the patient has shown no evidence of recurrence of either the palate cancer or the CCF.
Conclusion: CCF is commonly caused by direct head injury, but has rarely been reported after craniofacial surgery. We considered cutting of the pterygoid process as the reason for the occurrence of the CCF in this case. Appropriate and early treatment of CCF is useful for preventing the complications of cerebral infarction and bleeding.
