Neurological complications with acute sphenoid sinusitis a surgical emergency?

Poulopoulos, Markos; Finelli, Pasquale F.

doi:10.1007/s12028-007-0036-6

Cited by 19 publications

(13 citation statements)

References 10 publications

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“…Frontal sinus can be also drained endoscopically by performing the Draf techniques. For the ethmoid and sphenoid, endoscopic ethmoidectomy and sphenoidotomy can be performed [1] [4]. Endonasal surgery was performed in 3 cases of our series.…”

Section: Discussionmentioning

confidence: 99%

Management of Intracranial Complications of Sinusitis

Khamassi¹,

Mahfoudhi²,

Yahia³

et al. 2015

OJCD

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Intracranial complications of sinusitis are rare. However, they have an important morbidity and mortality rate, and can be a source of disabling neurological sequelae in the absence of a rapid diagnosis and adequate treatment. We carry a retrospective study of 23 patients having sinusitis with intracranial complications, treated between 1996 and 2011. All patients underwent complete ENT and neurological examination, biological investigations and sinonasal and cerebral CT. An intraveinous large-spectrum antibiotherapy was administered to all patients. Twenty patients underwent surgery. It included evacuation of the intracranial collection, sinus drainage, with or without cranialization of the frontal sinus. Evolution was assessed on clinical biological and radiological criteria. Mean age was 25 years and sex-ratio was 3.6. Neurological signs were the most frequent symptoms. Rhinological signs were essentially purulent rhinorrhea (14 cases) and nasal obstruction (12 cases). Nasal endoscopy showed pus in the middle meatus in 10 cases. On CT, intracranial complications included subdural empyema (11 cases), extradural empyema (7 cases) and brain abscess (5 cases). Associated cerebral thrombophlebitis was noted in 4 cases. Three patients with extradural empyema had had an exclusive medical treatment. All other patients (20 cases) were operated. Clinical and radiological evolution was favorable after initial treatment in 14 cases (60.8%). Six patients required secondary surgery. Two patients have died despite intensive care. The intracranial complications of sinusitis are serious and source of important morbidity and mortality. Management should rapid and adequate, combining effective antibiotic therapy and eventually neurosurgical treatment.

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Section: Discussionmentioning

confidence: 99%

Management of Intracranial Complications of Sinusitis

Khamassi¹,

Mahfoudhi²,

Yahia³

et al. 2015

OJCD

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“…The median (AEIQR) duration of symptoms at presentation was 11 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) days. Seven (26%) children presented with reduced Glasgow Coma Scale (GCS), and nine (33%) had evidence of hemiparesis.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…We have demonstrated that isolated sphenoid sinusitis can result in extra-axial and parenchymal abscesses of the anterior and middle cranial fossae, and will likely exist without significant rhinological symptoms. Various intracranial complications from isolated sphenoid sinusitis have been reported [14][15][16][17].…”

Section: Early Detection and Investigationsmentioning

confidence: 99%

Management and outcomes in children with sinogenic intracranial abscesses

Patel¹,

Masterson²,

Deutsch³

et al. 2015

International Journal of Pediatric Otorhinolaryngology

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“…These anatomical relationships explain some of the devastating complications that may occur in the setting of AISS, including blindness, 4 cavernous sinus thrombosis, meningitis, brain abscess, 5 and cranial nerve palsies. Gilony et al 2 reported an 8.3% major complication rate and a 2.9% mortality rate in cases of AISS.…”

Section: 3mentioning

confidence: 99%