Gutenberg A, Larsen J, Rohde V
Department of Neurosurgery, Georg-August-University Göttingen, Göttingen, Germany.
Cent Eur Neurosurg. 2009 May;70(2):95-7. doi: 10.1055/s-0028-1082060. Epub 2009 May 25.
The combination of paranasal sinus osteoma, mucocele and brain abscess is rare. Only one other case has been reported so far, where the cerebral abscess was diagnosed intraoperatively. We report here on a second patient with combined frontal sinus osteoma, intracerebral mucocele as well as cerebral abscess. However, in our case, the diagnosis of cerebral abscess was reached prior to surgery, which allowed for a tailored treatment strategy with abscess puncture under neuronavigational guidance and, after 3 weeks of antibiotic therapy with documented abscess shrinkage, osteoma and mucocele resection as well as reconstruction of the eroded dura.
鼻窦骨瘤、黏液囊肿和脑脓肿同时存在的情况较为罕见。迄今为止,仅报道过另一例病例,其脑脓肿是在术中确诊的。我们在此报告第二例合并额窦骨瘤、脑内黏液囊肿以及脑脓肿的患者。然而,在我们的病例中,脑脓肿在手术前就已确诊,这使得我们能够制定出一种有针对性的治疗策略,即在神经导航引导下进行脓肿穿刺,在抗生素治疗3周且脓肿缩小得到确认后,再进行骨瘤和黏液囊肿切除以及对侵蚀的硬脑膜进行重建。