Szyfter Witold, Bartochowska Anna, Borucki Łukasz, Maciejewski Adrian, Kruk-Zagajewska Aleksandra
Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, Przybyszewskiego Street 49, 60-355, Poznań, Poland.
Department of Rescue Medicine, University of Medical Sciences, Poznań, Poland.
Eur Arch Otorhinolaryngol. 2018 May;275(5):1165-1173. doi: 10.1007/s00405-018-4932-5. Epub 2018 Mar 13.
The objective of this study was to analyse 51 patients with intracranial complications of sinusitis treated in the Department of Otolaryngology and Laryngeal Oncology at Poznań University of Medical Sciences from 1964 to 2016.
Males made up a significant portion of study participants at 70.5%. Treatment included simultaneous removal of inflammatory focal points in the paranasal sinuses and drainage of cerebral and epidural abscesses and subdural empyemas under the control of neuronavigation preceded by the implementation of broad-spectrum antibiotics continuously for 4 weeks. Seventy-three intracranial complications were found among 51 patients. Of the 51 patients, 25 had frontal lobe abscesses (including multiple abscesses). Other complications included the following: 16 epidural abscesses, 9 subdural empyemas, 15 meningitis cases, 3 intracerebral abscesses, 3 sinus thrombosis cases and 2 patients with cerebritis. Co-occurrence of these complications worsened the state of the patient and increased the duration of treatment. Patients with frontal lobe abscesses had a better prognosis and less pronounced neurological symptoms in recent years versus earlier treatment approaches.
Simultaneous treatment of intracranial complications of sinusitis is an effective treatment method that has minimal burden for the patient. From 1964 to 1978, three deaths (17%) were reported among patients with these complications. Since 1978, no deaths were reported in the clinic.
本研究的目的是分析1964年至2016年在波兹南医科大学耳鼻喉科和喉肿瘤科接受治疗的51例鼻窦炎颅内并发症患者。
男性占研究参与者的很大一部分,为70.5%。治疗包括在神经导航控制下同时清除鼻旁窦的炎症病灶,引流脑脓肿、硬膜外脓肿和硬膜下积脓,在此之前连续使用广谱抗生素4周。51例患者共发现73例颅内并发症。在这51例患者中,25例有额叶脓肿(包括多发性脓肿)。其他并发症包括:16例硬膜外脓肿、9例硬膜下积脓、15例脑膜炎、3例脑内脓肿、3例窦血栓形成病例和2例脑炎患者。这些并发症的同时出现使患者病情恶化,延长了治疗时间。与早期治疗方法相比,近年来额叶脓肿患者的预后较好,神经症状也不那么明显。
鼻窦炎颅内并发症的同步治疗是一种有效的治疗方法,对患者的负担最小。1964年至1978年,这些并发症患者中有3例死亡(17%)。自1978年以来,该诊所未报告死亡病例。