Dolan R W, Chowdhury K
Department of Otolaryngology-Head and Neck Surgery, Boston University Medical Center, MA, USA.
J Oral Maxillofac Surg. 1995 Sep;53(9):1080-7. doi: 10.1016/0278-2391(95)90128-0.
Complications and local extension of paranasal sinus infections most often involve the orbit and periorbita. Because of the widespread use of antibiotics since World War II, intracranial extension of maxillofacial sinusitis is rarely seen today. Nevertheless, the clinician must be aware of the potential for these complications, because late recognition of this condition and delays in treatment can increase morbidity and mortality rates. A comprehensive, current review of sinogenic intracranial complications is presented, with illustrative cases of brain abscess, subdural empyema, meningitis, cavernous sinus thrombosis, epidural abscess, and osteomyelitis. The mechanisms and potential for intracranial spread of infection from the frontal, sphenoid, and ethmoid sinuses are discussed in detail. The management of each type of complication is outlined, including the use of computed tomography and magnetic resonance imaging, and the role of surgical drainage.
鼻窦感染的并发症及局部扩散最常累及眼眶和眶周组织。自第二次世界大战以来，由于抗生素的广泛使用，如今上颌窦炎向颅内扩散的情况已很少见。然而，临床医生必须意识到这些并发症发生的可能性，因为对这种情况的晚期识别和治疗延误可能会增加发病率和死亡率。本文对源自鼻窦的颅内并发症进行了全面的最新综述，并列举了脑脓肿、硬膜下积脓、脑膜炎、海绵窦血栓形成、硬膜外脓肿和骨髓炎的病例。详细讨论了感染从额窦、蝶窦和筛窦向颅内扩散的机制及可能性。概述了每种并发症的处理方法，包括计算机断层扫描和磁共振成像的应用以及手术引流的作用。
