Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-28T05:26:03.480Z Has data issue: false hasContentIssue false
  • English
  • Français

Intracranial complications of sinusitis: the need for aggressive management

Published online by Cambridge University Press:  29 June 2007

R. L. Jones ,
N. S. Violaris ,
S. V. Chavda  and
A. L. Pahor
R. L. Jones
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
N. S. Violaris
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
S. V. Chavda
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
A. L. Pahor*
Affiliation:
Midlands Centre for Neurology and Neurosurgery and the City Hospital, Birmingham
*
Mr A. L. Pahor, Department of Otorhinolaryngology, City Hospital NHS Trust, Dudley Road, Birmingham B18 7QH.
Get access Rights & Permissions [Opens in a new window]

Abstract

Sinus-induced intracranial sepsis can represent a genuine medical and surgical emergency. We review 12 cases presenting to our hospitals over a five-year period. Nine were male and three were female with an age range of 16 to 74 years (mean 35.5 years). Four patients had their sinusitis diagnosed prior to admission and eight did not. Nine patients had bilateral sinus disease, the most common sinus involved was the frontal followed by the ethmoid, maxillary and sphenoid. Neurosurgical drainage was via a craniotomy in seven cases and burr hole in three. Nine patients underwent sinus surgery and three did not. Of the nine who had sinus surgery three had frontal drainage, four fronto-ethmoidal and two transsphenoidal drainage. The most common organism was Streptococcus milleri. Our series confirms that sinus-induced intracranial sepsis is a serious problem needing early diagnosis and aggressive treatment. We would recommend a high index of suspicion of sinusitis in patients with intracranial infection.

Keywords

Paranasal sinus diseasescomplicationsInfectionintracranialSurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 11 , November 1995 , pp. 1061 - 1062
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 15th Congress of the European Rhinology Society (Copenhagen) June 1994.

References

Clayman, G. L., Adams, G. L., Paugh, D. R.. Koopman, C. F. (1991) Intracranial complications of paranasal sinusitis: a combined institutional review. Laryngoscope 101: 234–239.CrossRefGoogle ScholarPubMed
Hoyt, D. J., Fisher, S. R. (1991) Otolaryngologic management of patients with subdural empyema. Laryngoscope 101: 20–24.CrossRefGoogle ScholarPubMed
Johnson, D. L., Markle, B. M., Weiderman, B. L., Hanahan, L. (1988) Treatment of intracranial abscesses associated with sinusitis in children and adolescents. Journal of Paediatrics 113: 15–23.CrossRefGoogle ScholarPubMed
Kaufman, D. M., Miller, M. H., Steigbigel, N. H. (1975) Subdural empyema analysis of 17 recent cases and review of the literature. Medicine 54: 485–498.CrossRefGoogle ScholarPubMed
Kaufman, D. M., Litman, N., Miller, M. H. (1983) Sinusitis: induced subdural empyema. Neurology 33: 123 131.CrossRefGoogle ScholarPubMed
Maniglia, A. J., Goodwin, W. J., Arnold, J. E., Ganz, E. (1989) Intracranial abscess secondary to nasal sinus and infections in adults and children. Archives of Otolaryngology, Head and Neck Surgery 115: 1424–1429.CrossRefGoogle ScholarPubMed
Skelton, R., Maixner, W., Issacs, D. (1992) Sinusitis-induced sub-dural empyema. Archives of Disease in Childhood 67: 1478–1480.CrossRefGoogle Scholar
Weiner, G. M., Williams, B. (1993) Prevention of intracranial problems in ear and sinus surgery: a possible role for cefotaxime. Journal of Laryngology and Otology 107: 1005–1007.CrossRefGoogle ScholarPubMed