Université Cheikh Anta Diop, Dakar, Senegal.
Université Cheikh Anta Diop, Dakar, Senegal.
Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Dec;137(6):473-476. doi: 10.1016/j.anorl.2020.03.014. Epub 2020 Apr 9.
Locoregional complications of sinusitis are dominated by oculo-orbital and/or cranioencephalic manifestations that may be life-threatening or jeopardize functional prognosis. The aim of this study was to report epidemiological, diagnostic and therapeutic aspects.
A retrospective study included inpatients managed for sinusitis complications in the ENT and neurosurgery departments of the Fann university hospital center in Dakar, Senegal between January 1, 2005 and December 31, 2016.
In all, 80 files were collected. Mean age was 18.5 years, with male predominance. Mean time to treatment was 18.2 days. Cranio-encephalic complications were the most frequent (54 cases; 67.5%): mainly subdural empyema (30 cases) and brain abscess (10 cases). Seventeen patients (21.25%) had oculo-orbital complications: mainly orbital cellulitis (52.9%) and preseptal cellulitis (29.4%). Nine patients (11.25%) had both cranioencephalic and oculo-orbital complications. Acute sinusitis (82.5%) was the main cause of complications. 52.5% of patients showed pansinus involvement. Medical treatment consisted in broad-spectrum antibiotic therapy combining third-generation cephalosporins, metronidazole and gentamycin in cranio-encephalic complications and clavulanic acid and metronidazole in oculo-orbital complications. Thirty-four patients (42.5%) underwent surgical sinus drainage. Neurosurgical drainage was performed in 35 cases (43.75%). Post-treatment course was marked by 6.25% mortality (5 cases) and 16.25% sequelae.
With 6.25% mortality and a high rate of functional sequelae, complications of sinusitis are a serious concern in our region. Improving prognosis requires earlier management and better coordination between health professionals.
鼻窦炎的局部区域并发症以眼-眶和/或颅-脑表现为主，可能危及生命或影响功能预后。本研究旨在报告其流行病学、诊断和治疗方面的内容。
这是一项回顾性研究，共纳入 2005 年 1 月 1 日至 2016 年 12 月 31 日期间在塞内加尔达喀尔的法恩大学医院耳鼻喉科和神经外科住院治疗的鼻窦炎并发症患者。
共收集了 80 份病历。患者平均年龄为 18.5 岁，男性居多。平均治疗时间为 18.2 天。颅-脑并发症最为常见（54 例；67.5%）：主要为硬膜下脓肿（30 例）和脑脓肿（10 例）。17 例（21.25%）患者出现眼-眶并发症：主要为眶蜂窝织炎（52.9%）和眶隔前蜂窝织炎（29.4%）。9 例（11.25%）患者同时存在颅-脑和眼-眶并发症。急性鼻窦炎（82.5%）是并发症的主要原因。52.5%的患者表现为全鼻窦炎。治疗方法为广谱抗生素治疗，包括第三代头孢菌素、甲硝唑和庆大霉素治疗颅-脑并发症，克拉维酸和甲硝唑治疗眼-眶并发症。34 例（42.5%）患者行鼻窦切开引流术，35 例（43.75%）患者行神经外科引流术。治疗后，有 6.25%（5 例）的患者死亡，16.25%（5 例）的患者出现后遗症。
在我们地区，鼻窦炎并发症的死亡率为 6.25%，且功能后遗症发生率较高，是一个严重的问题。改善预后需要更早的治疗和卫生专业人员之间更好的协调。
