Image-guided Functional Endoscopic Sinus Surgery Complicated with Pneumocephalus

Image-guided surgery has played an important and expanding role in functional endoscopic sinus surgery (FESS) over the past two decades. Its impact on complications and clinical outcomes of FESS remains unclear. On the other hand, pneumocephalus is a very rare intracranial complication of FESS. We present a patient who underwent imaged-guided FESS under the impression of left chronic rhinosinusitis with nasal polyps. The operative course was uneventful. However, he felt weak and his speech became slurred 4 days after surgery, so he came to our emergency department. A brain CT revealed large pneumocephalus. The patient was admitted for conservative treatment and was asymptomatic half a year after surgery. Although Image-guided surgery has been widely used in FESS, major complications still occurred.