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sinusitis

Sinusitis

Intracranial complications of sinusitis are rare but life threatening.

Acute sinusitis

Chronic sinusitis

Ethmoidal sinusitis

see frontal sinusitis

Complications

Twenty-one patients with intracranial sinogenic complications were treated at the Department of Otolaryngology in Poznan during that time.

Brain abscesses were the most common complications. Intracranial complications of sinusitis rarely occurred in isolation, often coexisting with other intracranial pathologies. A significant increase in the incidence was recorded in 2013. Treatment involved concurrently alleviating inflammation in the sinuses through implementation of broad-spectrum antibiotics for several weeks and decompressing the organized intracerebral abscesses, empyema, epidural and/or subdural abscesses under control of neuronavigation. There were no patient deaths recorded in the analyzed period. Conclusions The risk of developing intracranial sinogenic complications is low but invariably present and should be included in the differential diagnosis. Since the incidence of intracranial complications may increase in the course of prevailing viral infection, it should raise diagnostic vigilance 1).

Case reports

A 17-year-old woman with sinusitis who deteriorated over the course of 12 days from subdural empyema and global purulent cerebral venous sinus thrombosis. The patient was managed with surgery and mechanical thrombectomy utilizing a novel 'stent anchor with mobile aspiration technique', in which a stent retriever Trevo XP ProVue Retriever (Stryker) was anchored in the superior sagittal sinus (SSS) while a 5MAX ACE reperfusion catheter (Penumbra) was passed back and forth from the SSS to the sigmoid sinus with resultant dramatic improvement in venous outflow. The patient was extubated on postoperative day 3 and was discharged with minimal lower extremity weakness on postoperative day 11. This is the first report using the Trevo stent retriever for sinus thrombosis. It is important to keep these rare complications in mind when evaluating patients with oral and facial infections 2).

1)
Szyfter W, Kruk-Zagajewska A, Bartochowska A, Borucki Ł. Intracranial complications from sinusitis. Otolaryngol Pol. 2015;69(3):6-14. doi: 10.5604/00306657.1156326. PubMed PMID: 26388244.
2)
Mascitelli JR, Pain M, Zarzour HK, Baxter P, Ghatan S, Mocco J. Sinus thrombectomy for purulent cerebral venous sinus thrombosis utilizing a novel combination of the Trevo stent retriever and the Penumbra ACE aspiration catheter: the stent anchor with mobile aspiration technique. BMJ Case Rep. 2015 May 22;2015. pii: bcr2015011782. doi: 10.1136/bcr-2015-011782. PubMed PMID: 26002667.
sinusitis.txt · Last modified: 2015/12/27 14:51 (external edit)