Complications of acute frontal sinusitis

TY - JOUR

T1 - Complications of acute frontal sinusitis

T2 - a retrospective study

AU - Betz, Christian S

AU - Issing, Wolfgang

AU - Matschke, Johannes

AU - Kremer, Anne

AU - Uhl, Eberhard

AU - Leunig, Andreas

PY - 2008/1

Y1 - 2008/1

N2 - Even though being a rare condition in the era of antibiotic treatment, complications of acute frontal sinusitis still pose a potentially life-threatening problem. We present a clinical case series using a combined surgical approach. Within a 7 year period, all patients with a suppurative complication of an acute frontal sinusitis were included into this retrospective study and evaluated concerning histories, diagnostic and therapeutic procedures and achieved outcomes. Twelve patients (11-74 years) were identified; this corresponds to 0.3% of all patients that have undergone paranasal sinus surgery and 15.4% of all patients with infectious complications of sinusitis. The cases could be subdivided as follows: intracranial complications (4/12), osteomyelitis of the frontal bone (4/12), frontal/orbital soft tissue involvement (3/12) and endoluminal empyema (1/12). These were all correctly diagnosed by CT and (especially in the cases of intracranial complications) MRI. The microbiological spectrum comprised mostly non-multiresistant Staphylococci and Streptococci. All patients received aggressive antibiotic and combined surgical treatment. Within a mean follow up period of 32 months, the disease-related mortality and the rate of severe long-term ailment was 0%. If detected and treated early, both long-term morbidity and mortality can be minimised. A close cooperation with the related specialties (neurosurgery, ophthalmology, radiology) is thereby of utmost importance.

AB - Even though being a rare condition in the era of antibiotic treatment, complications of acute frontal sinusitis still pose a potentially life-threatening problem. We present a clinical case series using a combined surgical approach. Within a 7 year period, all patients with a suppurative complication of an acute frontal sinusitis were included into this retrospective study and evaluated concerning histories, diagnostic and therapeutic procedures and achieved outcomes. Twelve patients (11-74 years) were identified; this corresponds to 0.3% of all patients that have undergone paranasal sinus surgery and 15.4% of all patients with infectious complications of sinusitis. The cases could be subdivided as follows: intracranial complications (4/12), osteomyelitis of the frontal bone (4/12), frontal/orbital soft tissue involvement (3/12) and endoluminal empyema (1/12). These were all correctly diagnosed by CT and (especially in the cases of intracranial complications) MRI. The microbiological spectrum comprised mostly non-multiresistant Staphylococci and Streptococci. All patients received aggressive antibiotic and combined surgical treatment. Within a mean follow up period of 32 months, the disease-related mortality and the rate of severe long-term ailment was 0%. If detected and treated early, both long-term morbidity and mortality can be minimised. A close cooperation with the related specialties (neurosurgery, ophthalmology, radiology) is thereby of utmost importance.

KW - Acute Disease

KW - Adolescent

KW - Adult

KW - Aged

KW - Brain Abscess

KW - Child

KW - Epidural Abscess

KW - Female

KW - Frontal Bone

KW - Frontal Sinusitis

KW - Humans

KW - Male

KW - Middle Aged

KW - Osteomyelitis

KW - Young Adult

KW - Case Reports

KW - Journal Article

U2 - 10.1007/s00405-007-0411-0

DO - 10.1007/s00405-007-0411-0

M3 - SCORING: Journal article

C2 - 17676328

VL - 265

SP - 63

EP - 72

JO - EUR ARCH OTO-RHINO-L

JF - EUR ARCH OTO-RHINO-L

SN - 0937-4477

IS - 1

ER -