Intracranial complications of pediatric sinusitis.
OBJECTIVE
To study intracranial extension of pediatric sinusitis, an infrequent but potentially fatal complication.


METHODS
Ten-year retrospective review at a tertiary children's hospital identified 21 cases of intracranial complications of sinusitis.


RESULTS
Thirteen males and eight females with mean age of 13.3 years were identified. Overall 18 of 21 (81%) exhibited abscess formation, most commonly epidural. Only 3 of 21 (14%) had meningitis alone. All but 4 patients were managed surgically, requiring craniotomy in 13 of 21 (61.9%) and endoscopic sinus surgery (ESS) in 10 of 21 (48%). Seven patients (33%) required multiple operations during admission. Nineteen patients (90%) had a total of 30 organisms cultured. Oral flora was observed in 12 of 21 (57%). Polymicrobial infections, seen in 9 of 21 (43%), were significantly associated with the need for craniotomy (P=0.02). Mean hospital stay was 15 days, and mean length of IV antibiotic was 5 weeks.


CONCLUSIONS
Intracranial complications of pediatric sinusitis often require craniotomy. Oral flora and polymicrobial infections were prominent in this series.


METHODS
C-4.
Glickstein
Jonathan S
JS
University of Tennessee Health Science Center, Department of Otolaryngology-Head and Neck Surgery, 956 Court Ave Suite B224, Memphis, TN 38163, USA. jglickstein@utmem.edu
Chandra
Rakesh K
RK
Thompson
Jerome W
JW
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000209:etiology / Q000601:surgery; D020806:Central Nervous System Bacterial Infections / Q000209:etiology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D013354:Empyema, Subdural / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008581:Meningitis / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000209:etiology / Q000601:surgery; D012852:Sinusitis / Q000150:complications* / Q000188:drug therapy
D000900:Anti-Bacterial Agents