Neurological Complications of Acute and Chronic Sinusitis

Ziegler, Andrea; Patadia, Monica; Stankiewicz, James A.

doi:10.1007/s11910-018-0816-8

Cited by 49 publications

(50 citation statements)

References 35 publications

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“…Several studies have shown that sinusitis-induced intracranial abscesses occur more commonly among adolescents and young adults in their 20s and 30s. 3,12,17,18 Our results are inconsistent with those of previous studies; we found that abscesses occur at any age, although the reason remains unclear.…”

Section: Discussioncontrasting

confidence: 99%

“…Direct extension via osteomyelitis of the sinus walls or bony defects (congenital or posttraumatic) is uncommon. 6,18 Thus, the effect of drainage from the sinus may be limited. The present study showed no significant benefit of ESS in terms of reducing in-hospital mortality, blood transfusion, readmission, revision neurosurgery, or length of stay.…”

Section: Discussionmentioning

confidence: 99%

“…2 With respect to neurosurgical procedures, previous studies have shown that patients with meningitis and a small intracranial abscess (< 1 cm) without significant mass effect can be managed by antibiotics without neurosurgical procedures. 2,18 A systematic review involving 16 studies and 180 pediatric patients (age < 18 years) did not reveal the outcomes of ESS. 10 Large studies are necessary to evaluate the role of ESS in the intracranial complications of sinusitis.…”

mentioning

confidence: 99%

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Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

Koizumi

Ishimaru

Matsui

et al. 2019

Neurosurgical Focus

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OBJECTIVEAlthough sinusitis-induced intracranial complications rarely occur in the current era of antibiotics, they can induce neurological symptoms or death. The authors of this study investigated the association between endoscopic sinus surgery (ESS) and outcomes in patients who had undergone neurosurgical procedures for sinusitis-induced intracranial abscess.METHODSThe authors obtained data on patients with sinusitis-induced intracranial abscess from the Japanese Diagnosis Procedure Combination inpatient data for the period from 2010 to 2017. They excluded patients with fungal sinusitis, orbital complications, immunodeficiency, and malignant disease. They also excluded patients who had received antifungal agents, chemotherapy, immunosuppressants, and antidiabetic drugs. Eligible patients were divided into those with and those without neurosurgical procedures. Propensity score–adjusted regression analyses were performed to examine the association between ESS within the same hospitalization and outcomes (mortality, blood transfusion, readmission, revision neurosurgery, and length of stay).RESULTSOf the 552 potentially eligible patients, 255 were treated with neurosurgical procedures, including 104 who underwent ESS within the same hospitalization and 151 who did not. ESS was not significantly associated with mortality (OR 0.54, 95% CI 0.05–5.81, p = 0.61), blood transfusion (OR 1.95, 95% CI 0.84–4.51, p = 0.12), readmission (OR 0.86, 95% CI 0.34–2.16, p = 0.75), revision neurosurgery (OR 0.65, 95% CI 0.24–1.74, p = 0.39), or length of stay (percent difference −10.8%, 95% CI −24.4% to 5.1%, p = 0.18).CONCLUSIONSThe present study suggests that ESS may not have significant benefits with respect to reducing mortality, blood transfusion, readmission, revision neurosurgery, or length of stay.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

Koizumi

Ishimaru

Matsui

et al. 2019

Neurosurgical Focus

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“…Chronic infections of the frontal sinus are difficult to treat and may lead to serious complications. Given the close anatomical relationship of the frontal sinus to the orbit and anterior cranial base, infection may spread intracranially via foramina of Breschet or posterior table violation leading to meningitis, venous sinus thrombosis, orbital infection, subperiosteal abscess (i.e., Pott's puffy tumor), and brain abscess . Osteomyelitis of the frontal bone can lead to resistant infection and unsalvageable bone.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic infection of the frontal sinus poses a challenging clinical problem. Unresolved infection can lead to serious orbital or intracranial complications given the proximity of the frontal sinus to these structures . Furthermore, chronic infection may lead to osteomyelitis of fragmented, devitalized bone, which may be unsalvageable …”

Section: Introductionmentioning

confidence: 99%

The Role of Free Tissue Transfer in the Management of Chronic Frontal Sinus Osteomyelitis

et al. 2018

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Objectives/Hypothesis Chronic frontal sinus infection is managed with a combination of medical and surgical interventions. Frontal bone osteomyelitis due to recurrent infection following trauma or prior open surgery may require more significant debridement. Free tissue transfer may allow for extensive debridement with replacement of tissue, and definitive eradication of osteomyelitis. Study Design Retrospective chart review. Methods Patients undergoing free flap obliteration of the frontal sinus for frontal bone osteomyelitis at a single institution were included in the study. Clinical, radiologic, and surgical data were collected. Surgeries before and after free flap obliteration were compared by Wilcoxon signed rank test. Results Fifteen patients were identified; however, one patient had less than 6 months of follow‐up and was excluded from analysis. Of the remaining 14 patients, mean follow‐up duration was 26 months (range, 6–120 months). Mean number of surgeries prior to free flap was 3.7 (range, 1–8 surgeries). Free flap obliteration resolved chronic frontal sinusitis in all patients. Two patients experienced postoperative infection, and the overall complication rate was 29%. Eight patients underwent cranioplasty (six immediate, two delayed) without complication. All patients received planned courses of postoperative antibiotics. A statistically significant decrease in the number of surgeries after free flap obliteration was observed P ≤ .01). Conclusions Extensive debridement followed by free tissue transfer and antibiotics offers a definitive treatment for complicated, recurrent frontal osteomyelitis. Simultaneous cranioplasty provides immediate protective and aesthetic benefit without complication. Consideration should be given for free tissue transfer and cranioplasty earlier in the algorithm for treatment of refractory frontal sinus osteomyelitis. Level of Evidence 4 Laryngoscope, 129:1497–1504, 2019

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Diagnostic usefulness of cone‐beam computed tomography versus multi‐detector computed tomography for sinonasal structure evaluation

Han

Kim

Choi

et al. 2022

Laryngoscope Investig Oto

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Objective: Cone-beam computed tomography (CBCT) is a promising imaging modality for sinonasal evaluation, with advantages of relatively low radiation dose, low cost, and quick outpatient imaging. Our study aimed to compare the diagnostic performance and image quality of CBCT with those of multi-detector computed tomography (MDCT) with different slice thickness. Methods:We retrospectively reviewed 60 consecutive patients who had undergone both CBCT and MDCT. MDCT images was reconstructed with 1 and 3 mm slice thickness. The quantitative image quality parameters (image noise, signal-to-noise ratio [SNR], and contrast-to noise ratio [CNR] were calculated and compared between the two imaging modalities. Two observers (ENT surgeon and neuroradiologist) evaluated the presence of seven sinonasal anatomic variations in each patient and interobserver agreements were analyzed. The diagnostic performance of CBCT (0.3 mm) and MDCT (3 mm) was assessed and compared with that of high resolution MDCT (1 mm), which is considered as the gold standard.Results: The image noise was significantly higher and SNR and CNR values were lower in the CBCT (0.3 mm) group than in the MDCT groups (1 and 3 mm). The diagnostic performance of CBCT (0.3 mm) was similar to that of MDCT (1 mm) and superior to that of MDCT (3 mm). The highest interobserver agreement was for high resolution MDCT (1 mm), followed by CBCT (0.3 mm), and MDCT (3 mm). Conclusion:Considering its low radiation dose, low cost, and ease of clinical access, CBCT may be a useful imaging modality for as first line sinonasal evaluation and repeated follow up.Study design: Retrospective study in a tertiary referral university center.Level of evidence: NA.

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Neurological Complications of Acute and Chronic Sinusitis

Cited by 49 publications

References 35 publications

Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

The Role of Free Tissue Transfer in the Management of Chronic Frontal Sinus Osteomyelitis

Diagnostic usefulness of cone‐beam computed tomography versus multi‐detector computed tomography for sinonasal structure evaluation

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