Intracranial complications of otorhinological infections

Abstract

Despite the reduction in the incidence of intracranial complications of otorhinological infections after the coming of the antimicrobial therapy, these stay as extremely serious affections.The purpose of this re p o rt was to analyze re t ro s p e ctively the intracranial complications of rh i n o s i n u s i t i s and otitis media in patients interned in the neurosurgical unit at Hospital Governador João Alves Filho in Aracaju -SE, between january of 1995 and september of 2004.T h i rty patients were studied, being 57% of the masculine gender and 43% feminine. With re g a rd to the age, there was a prevalence in the first and second decades of life (83,3%). The source of infections was rhino-sinusitis in 70% of the patients and otitis media in 30%. The most commom form of complicationwas a intracranial abscess (53%), followed by subdural empyema (40%) and extradural abscess (7%). The main clinical pre s e n t a t i o n s were headache (86,7%), altered consciousness (80%), fever (76,7%) and vomit (76,7%). About the location of the lesions, 66,7% of the intracranial abscesses of rhinosinoseginc origin were located in the frontal lobe, while 57,1% of those of otologic origin were located in the cerebellum. The subdural empyemas were located in convexity in 58,3% of the cases. One extradural abscess was located in the frontal lobe and another in parietaland occipital lobes.Surgical treatment was undertaken in 23 patients, while 7 patients were treated without surg e ry. Seventhy p e rcent of the patients survived and 52,4% of these p resented sequelaes, being the hemiparesia the most fre-THESES quent (63,6%). It is concluded that the otorhinological intracranial complications are quite serious illness, with high mortality rate and frequent sequelaes.

Parietal subdural empyema as complication of acute odontogenic sinusitis: a case report

“…For the first time, we present an unusual case described in literature of a parietal subdural empyema secondary to acute odontogenic sinusitis, resulting from a tooth extraction (Table 2) [2,3,7,11,18,20,23]. According to Clayman et al ., odontogenic sinusitis accounts for approximately 10% of cases of all maxillary sinusitis [2].…”

“…The choice of surgical approach depends on the involved sinus and can include maxillary irrigation, external frontoethmoidectomy, sphenoid sinusotomy, antral washout, and frontal trephine. With the advent of endoscopy in treatment of sinusitis, the external approach has been less utilized [23]; according to some authors [3,24,25,30,31], we adopted the external approach for a complete curettage of the maxillary sinus.…”