Şimşek Hakan
a Department of Neurosurgery , Gülhane Military Medical Academy, Haydarpaşa Teaching Hospital , Istanbul , Turkey.
Br J Neurosurg. 2019 Jun;33(3):275-277. doi: 10.1080/02688697.2017.1330944. Epub 2017 May 22.
Chronic sinusitis can be complicated with erosion of anterior or posterior wall of the sinus; causing Pott's puffy tumour in the anterior, or epidural abscess in the posterior communication. A 65-year old man with a painful swelling in his forehead is presented. Pott's puffy tumour was diagnosed. CT, MRI, and DTI studies were obtained. Epidural or dural involvement was not present. In the first operation, anterior wall of the frontal sinus wall was opened. Osteomyelitis debridement was performed and the frontonasal duct was enlarged endoscopically. Antibiotics were commenced and were continued for 6 weeks. In the second operation, nasal septum deviation was fixed. Postoperative course was uneventful. The presented case suggests that treatment of sinus osteomyelitis should comprise immediate surgical drainage and osteomyelitis debridement followed by long-term administration of antibiotics. MRI study with contrast should be obtained to rule out epidural abscess and dural infiltration.
慢性鼻窦炎可并发鼻窦前壁或后壁侵蚀；在前部可导致波特氏浮肿性肿瘤，或在后部交通处导致硬膜外脓肿。本文介绍了一名65岁前额疼痛肿胀男子的病例。诊断为波特氏浮肿性肿瘤。进行了CT、MRI和DTI检查。未发现硬膜外或硬膜受累。在第一次手术中，打开了额窦前壁。进行了骨髓炎清创术，并在内窥镜下扩大了鼻额管。开始使用抗生素并持续6周。在第二次手术中，矫正了鼻中隔偏曲。术后过程顺利。该病例表明，鼻窦骨髓炎的治疗应包括立即进行手术引流和骨髓炎清创术，随后长期使用抗生素。应进行增强MRI检查以排除硬膜外脓肿和硬膜浸润。
