Patron Vincent, Orsel Stéphane, Caire François, Aubry Karine, Jégoux Franck
Limoges University Hospital Center, Limoges, France, Rennes University Hospital Center, Rennes, France.
Surg Innov. 2010 Dec;17(4):300-5. doi: 10.1177/1553350610380933. Epub 2010 Sep 3.
The frontal lobe is the second most common location for brain abscess after the temporal lobe. Since the advent of computed tomography and magnetic resonance imaging scanning, diagnosis has become easier, but the prognosis of brain abscess is still poor. Treatment is based on antimicrobial therapy and neurosurgical evacuation, but controversy still remains as to the merits place of each.
This study describes 2 cases of patients with frontal abscesses treated by endonasal transethmoidal sinus surgery (ESS) and reviews the literature on this topic.
Follow-up revealed no cerebrospinal fluid leak in both patients, complete abscess drainage in one patient, and incomplete drainage in the other.
ESS drainage of frontal abscesses is feasible in intracerebral and epidural abscesses if they have a thick shell and are in contact with the skull base. The procedure is minimally invasive and relatively simple. It allows for rapid microbial identification and an effective drainage.
额叶是仅次于颞叶的脑脓肿第二常见发病部位。自从计算机断层扫描和磁共振成像扫描问世以来，诊断变得更加容易，但脑脓肿的预后仍然很差。治疗基于抗菌治疗和神经外科引流，但对于每种方法的优点仍存在争议。
本研究描述了2例经鼻内镜经筛窦手术（ESS）治疗的额叶脓肿患者，并回顾了关于该主题的文献。
随访发现两名患者均无脑脊液漏，一名患者脓肿完全引流，另一名患者引流不完全。
如果额叶脓肿有厚壁且与颅底接触，经鼻内镜经筛窦手术引流在脑内和硬膜外脓肿中是可行的。该手术微创且相对简单。它能够快速进行微生物鉴定并实现有效引流。
