An unusual complication of posterior packing in epistaxis

Abstract

Endonasal or transnasal procedures are sometimes necessary in patients with head trauma. Before these procedures, theintegrity of the skull base must be considered to avoid penetration of the cranial vault. A 54-year-old man was taken to adistrict hospital following a car accident. After the initial assessment and emergency treatment, he was transferred to ouremergency clinic for further examination. The patient had massive nasal bleeding, though a Foley catheter had been insertedto control posterior bleeding. Computed tomography (CT) revealed that the catheter was not positioned correctly and was inthe cranial vault. Several fractures of the maxillofacial and cranial bones and cervical vertebrae were detected on CT. He alsohad right hemothorax and bilateral brain contusions. Endonasal insertion of catheters or tubes in trauma patients without acomplete assessment of the skull base can cause serious complications.