Hallak Bassel, Bouayed Salim, Ghika Joseph André, Teiga Pedro S, Alvarez Vincent
Department of Otorhinolaryngology, Head and Neck Surgery, Sion Hospital, Sion, Switzerland.
Department of Neurology, Sion Hospital, Sion, Switzerland.
Allergy Rhinol (Providence). 2022 Sep 25;13:21526575221125031. doi: 10.1177/21526575221125031. eCollection 2022 Jan-Dec.
Sinusitis or rhinosinusitis is a very common disease worldwide, and in some cases, it leads to intracranial complications (ICS). These are more common in immunocompromised patients or with underlying comorbidities, but even healthy individuals, can be affected. Nowadays, ICS have become less common thanks to improved antibiotic therapies, radiological diagnostic methods, surgical techniques and skills. Nonetheless, they can still cause significant morbidity and mortality. For this reason, management of these complications requires a multidisciplinary approach to plan and customize treatment options. This paper presents our strategy in the management of a series of intracranial complications induced by acute sinusitis and compares our experience and outcomes with the literature.
Single institute experience, retrospective analysis of cases series and literature review.
Adult and child patients who were treated for ICS in the Department of Otorhinolaryngology at Sion Hospital, in Switzerland from 2016 to 2020 were included. Their symptoms, medical history, clinical and radiological findings, treatment, and outcome were documented.
Eight patients (6 males- 2 females) aged from 14 to 88 y.o., were enrolled. None had any previous history of chronic, or recurrent sinusitis. Moreover, very few presented specific rhinological symptoms, but with neurological or other symptoms. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) were used to confirm the diagnosis of all ICS. All types of known intracranial complications were observed in our cohort with a wide range of extension and severity of sinusitis. A multidisciplinary approach with individual treatments was tailored to each patient. Outcomes were favorable in almost all patients with neither recurrence, nor neurological sequels being observed in the follow-up. Only one patient was lost due to fatal complications of advanced lung cancer.
ICS remain a challenging clinical problem due to substantial associated morbidity and mortality. The incidence of these complications is relatively low. Therapeutical management guidelines are lacking. Early detection and multidisciplinary approach are key to successful treatment.
鼻窦炎或鼻-鼻窦炎是一种在全球范围内非常常见的疾病，在某些情况下，它会导致颅内并发症（ICS）。这些并发症在免疫功能低下的患者或有基础合并症的患者中更为常见，但即使是健康个体也可能受到影响。如今，由于抗生素治疗、放射诊断方法、手术技术和技能的改进，颅内并发症已变得不那么常见。尽管如此，它们仍然可能导致严重的发病率和死亡率。因此，这些并发症的管理需要多学科方法来规划和定制治疗方案。本文介绍了我们在处理一系列由急性鼻窦炎引起的颅内并发症方面的策略，并将我们的经验和结果与文献进行了比较。
单机构经验、病例系列回顾性分析和文献综述。
纳入2016年至2020年在瑞士锡永医院耳鼻喉科接受颅内并发症治疗的成年和儿童患者。记录他们的症状、病史、临床和放射学检查结果、治疗情况及结果。
共纳入8例患者（6例男性，2例女性），年龄在14岁至88岁之间。既往均无慢性或复发性鼻窦炎病史。此外，很少有患者出现特定的鼻科症状，而是表现为神经或其他症状。计算机断层扫描（CT）和磁共振成像（MRI）用于确诊所有颅内并发症。在我们的队列中观察到了所有类型的已知颅内并发症，鼻窦炎的范围和严重程度各不相同。针对每位患者制定了个体化治疗的多学科方法。几乎所有患者的预后良好，随访中未观察到复发或神经后遗症。只有1例患者因晚期肺癌的致命并发症而死亡。
由于颅内并发症相关的高发病率和死亡率，它仍然是一个具有挑战性的临床问题。这些并发症的发病率相对较低。缺乏治疗管理指南。早期发现和多学科方法是成功治疗的关键。
