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美容性鼻成形术的严重并发症虽较少见,但也应引起注意。本文作者们全面复习了有关文献,将鼻成形术后的并发症分为感染、损伤、出血、全身和其他五类。感染鼻成形术后可由少见的细菌引起局部并发症如放线菌病、假单胞菌性肉芽肿等。常见的颅内感染是脑膜炎、脑炎、硬脑膜下积脓、脑脓肿及海绵窦栓塞。感染可直接侵入手术时受损伤的鼻腔粘骨膜的静脉和淋巴而入颅内。海绵窦通过眼静脉和翼丛导血管引流鼻和面部回血,该处静脉无瓣膜,因此海绵窦易发生脓毒栓塞。Rosenvold 将感染向颅内扩散的途径列为:①骨的自然裂隙,②损伤性缺损,③逆行性血栓性静脉炎,④骨髓炎,⑤嗅神经外鞘。也可因鼻腔填塞使隐性鼻窦炎发作或由急性鼻窦炎所引起。Her-zon 发现,用凡士林纱条填塞鼻腔的12个病人都能分离出革兰氏阳性和阴性菌,而用抗生素纱条填塞的16个病人中,10人可分离出革兰氏阳性菌,
Although the serious complications of cosmetic rhinoplasty are rare, they should also be noticed. The authors reviewed the literature comprehensively and classified complications after rhinoplasty as infection, injury, bleeding, systemic, and other five categories. Infectious rhinoplasty may cause local complications such as actinomycosis, pseudomonas granuloma, etc., caused by rare bacteria. Common intracranial infections are meningitis, encephalitis, subdural empyema, brain abscess and cavernous sinus embolism. Infection can be directly invaded during surgery damaged nasal mucoperiosteal veins and lymphatic into the skull. Cavernous sinus drainage through the ocular veins and wing plexus diversion nasal and facial blood back, where there is no venous valve, so susceptible to cavernous sinus embolism. Rosenvold will be infected with intracranial diffusion as follows: ① natural fracture of bone, ② injury, ③ retrograde thrombophlebitis, ④ osteomyelitis, ⑤ olfactory nerve sheath. Can also be caused by nasal packing occult sinusitis attack or caused by acute sinusitis. Her-zon found that Gram-positive and -negative bacteria were isolated in 12 patients who filled their nasal passages with vaseline gauze, whereas 10 out of 16 patients filled with antibiotic gauze could isolate gram-positive bacteria,