Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, 1st Medical Faculty, Charles University, Prague, Czech Republic.
Rhinology. 2010 Dec;48(4):457-61. doi: 10.4193/Rhin09.030.
BACKGROUND/OBJECTIVES: Nowadays, intracranial abscess is a rare complication of acute rhinosinusitis. The consequent orbital and intracranial complications of acute rhinosinusitis are rare but must be mutually excluded in complicated rhinosinusitis even when proper surgical and medical treatment tend to efficiently heal the orbital complication.
We report a case of a patient who primarily revealed symptoms of orbitocellulitis as a complication of odontogenous rhinosinusitis. Proper diagnostic and therapeutical measures were undertaken to manage the disease immediately after stationary admission.
Two weeks after an inconspicuous healing period, hemiparesis due to formation of an intracranial abscess developed. An emergent situation reveals which was unusual to the clinical situation.
The possible role of underlying mechanisms of intracranial abscess formation is discussed and review of literature concerning orbital and intracranial rhinosinusitis complications is performed. The correct indication of imaging methods and accurate evaluation of diminutive symptoms are essential. We assume that performance of a complementary CT of the brain or MRI even when previous CT scan of the orbit/paranasal sinuses reveals no cerebral pathology should be done to avoid or minimize future patients with consecutive orbital and intracranial complications of acute rhinosinusitis.
背景/目的:如今,颅内脓肿是急性鼻窦炎的罕见并发症。急性鼻窦炎的随之而来的眶内和颅内并发症较为罕见,但在复杂的鼻窦炎中必须相互排除,即使适当的手术和药物治疗往往可以有效地治愈眶内并发症。
我们报告了一例主要表现为牙源性鼻窦炎并发症的眶蜂窝织炎的患者。在住院后立即采取了适当的诊断和治疗措施来管理该疾病。
在无明显愈合期 2 周后,由于颅内脓肿形成而出现偏瘫。紧急情况的出现与临床情况不符。
讨论了颅内脓肿形成的潜在机制的可能作用,并对涉及眶内和颅内鼻窦炎并发症的文献进行了回顾。正确指示成像方法和准确评估微小症状至关重要。我们假设即使先前的眼眶/鼻窦 CT 扫描未显示脑部病理学,也应进行脑 CT 或 MRI 的补充检查,以避免或最小化急性鼻窦炎的后续眶内和颅内并发症的发生。