Touchette Charles J, Crevier Louis, Weil Alexander G
Division of Neurosurgery, Department of Surgery, Université de Sherbrooke, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.
Pediatric Neurosurgery Service, Department of Surgery, Sainte-Justine University Hospital Center, Montreal University, Montreal, Québec, Canada.
Pediatr Neurosurg. 2020;55(1):67-71. doi: 10.1159/000503055. Epub 2020 Jan 21.
In children, epidural and/or subdural intracranial empyema can complicate frontal sinusitis or pansinusitis. The standard transcranial approach used to treat epidural or subdural empyema has many drawbacks, but these can be avoided with an endoscopic expanded endonasal approach (EEA). To support the feasibility and advantages of this approach, we report the successful drainage through endoscopic EEA of a bifrontal empyema caused by an intracranial extension of pansinusitis. Our case and the ones previously reported in the literature establish well that endoscopic EEA offers several advantages over the standard craniotomy. Hence, EEA should be considered as an alternative to the transcranial approach when surgically draining anterior skull base empyema resulting from pansinusitis in children.
在儿童中，硬膜外和/或硬膜下颅内积脓可使额窦炎或全鼻窦炎复杂化。用于治疗硬膜外或硬膜下积脓的标准经颅入路有许多缺点，但通过内镜扩大经鼻入路（EEA）可避免这些缺点。为了支持这种入路的可行性和优势，我们报告了通过内镜EEA成功引流由全鼻窦炎颅内扩展引起的双侧额叶积脓的病例。我们的病例以及文献中先前报道的病例充分证明，内镜EEA比标准开颅手术具有若干优势。因此，当手术引流儿童全鼻窦炎导致的前颅底积脓时，EEA应被视为经颅入路的替代方法。
