Intracranial complications of acute sinusitis in children: The role of endoscopic sinus surgery

Management of complicated pediatric rhinosinusitis in the COVID-19 era

“…Derangements in coagulation profiles and the resulting sequalae in patients with COVID-19 have been previously reported throughout the pandemic, including myocardial infarction, ischemic stroke, limb ischemia, and cerebral venous thrombosis among others [ [14] , [15] , [16] , [17] ]. Urgent ESS in Case I was felt necessary to decrease the risk of developing cavernous sinus thrombosis and further neurologic complications [ 1 ]. In contrast, Case II responded well to initial orbital abscess drainage and improved clinically without immediate need for ESS.…”

“…Complicated rhinosinusitis is defined as the sequelae of direct extension of acute rhinosinusitis to adjacent structures [ 1 , 2 ]. Sequelae of complicated rhinosinusitis include orbital complications, such as preseptal cellulitis, subperiosteal abscess, orbital cellulitis, orbital abscess, and cavernous sinus thrombosis [ [1] , [2] , [3] , [4] ]. Intracranial complications also can occur, resulting in meningitis, epidural abscess, subdural abscess, intracerebral abscess, and osteomyelitis of the frontal bone [ 5 ].…”

Endoscopic transplanum drainage of epidural abscess in a pediatric patient

“…Since the 1970s, the mainstays of intracranial abscess management have been intravenous antibiotics and neurosurgical drainage of the abscess, either by stereotactic aspiration via burr hole or open craniotomy. 1,4,8,10,11 These approaches have remained standard due to the surgeon's ability to reduce mass effect, remove microbial burden, irrigate the abscess cavity, and in the open approach utilize two-handed instrumentation. 8 The established management of a planum sphenoidale epidural abscess in a young child with poorly pneumatized sphenoid sinuses would be transbasal craniotomy in conjunction with intravenous antibiotics.…”

Imaging in Sinonasal Disorders

“…Intracranial spread is most commonly seen in frontal and ethmoid ARS and presents as complications that include epidural and brain abscesses, subdural empyema, meningitis, and cavernous sinus thrombosis [11].…”