Complications of acute frontal sinusitis: a retrospective study.
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.
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilian University, Munich, Germany.
Christian S
CS
Betz
Wolfgang
W
Issing
Johannes
J
Matschke
Anne
A
Kremer
Eberhard
E
Uhl
Andreas
A
Leunig
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001922:Brain Abscess / Q000209:etiology; D002648:Child; D020802:Epidural Abscess / Q000209:etiology; D005260:Female; D005624:Frontal Bone; D015522:Frontal Sinusitis / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology; D055815:Young Adult