Endoskopowe leczenie chorych z wewnàtrzczaszkowymi powikłaniami zapalenia zatok
Journal Title: Otolaryngologia Polska - Year 2007, Vol 61, Issue 2
Abstract
Introduction. Intracranial complications of sinusitis (cerebral, epidural, and subdural abscesses, meningitis, and dural sinus thrombophlebitis) remain a challenging and current topic. Although they are nowadays relatively rare, prompt recognition of these disease states is important to prevent permanent neurological deficit or fatality. Infection may spread hematogenously or by direct extension. Patients with complications require surgery to remove the focus of infection from the sinuses and drain the abscess. Recently, endoscopic frontal and sphenoid sinus surgery has emerged as the preferred technique for the treatment of the most advanced and complicated chronic sinusitis. Material and methods. Records of 7 patients aged from 13 to 65 (mean 30.6) years treated in our department for intracranial complications between January 2002 and September 2006 were analysed retrospectively. The diagnosis of meningitis was established in 2 patients, in one case with accompanying bilateral oculomotor nerve palsy. Cavernous sinus thrombosis, frontal abscess with hemiplegia, cerebral oedema, bilateral oculomotor nerve palsy and retrobulbar optic nerve neuritis with blindness was diagnosed each in one individual. 5 endoscopic bilateral frontosphenoethmoidectomies and 2 endoscopic sphenoethmoidectomies were performed. In one case a frontosphenoethmoidectomy was combined with craniotomy. Results. All preoperative symptoms subsided in 4 operated individuals. Vision improved in the patient with bilateral retrobulbar optic nerve neuritis. In patients with hemiplegia and bilateral oculomotor nerve palsy the symptoms persisted. No complications of the surgery were observed. Conclusions. Surgical treatment of the focus of infection in the sinuses can be accomplished endoscopically via an intranasal approach with less morbidity, easy identification of anatomical structures, physiological drainage of the sinuses and superior cosmetic effects.
Authors and Affiliations
Paweł Stręk, Olaf Zagólski, Jacek Składzień, Krzysztof Oleś, Karolina Hydzik-Sobocińska, Daniel Najdzionek, Roman Głowacki
Keywords
Related Articles
- EP ID EP51367
- DOI -
- Views 117
- Downloads 0
Przewlekłe zapalenie ucha środkowego maskujące rozwój nowotworu – opis przypadku
The authors would like to present a rare case of the middle ear cancer which has been developed in postoperative cave in 67 years old patient operated for cholesteatoma 50 years earlier. The patient was admitted to the E...
Treatment of fungal infections of upper respiratory tract and ear
Fungi, in comparison with other pathogenic factors, have high pathogenecity. The number of fungal species which are able to infect people is over 500. The upper respiratory tract and ear have permanent contact with exter...
Acinic cell carcinoma ślinianki przyusznej o nietypowym obrazie klinicznym i niekorzystnym przebiegu
Differential diagnosis of neck tumours puts precedence on diagnosing neoplastic lesions. In the case of neck tumours, these are unfortunately late signs , but in patients with a primary neoplastic focus within the head a...
Technika czterech rąk w operacjach endoskopowych nosa i zatok przynosowych – doświadczenia własne
Endoscopic surgery in chronic sinusitis became a gold standard since Stammberger and Kennedy describe there technique in ’80 s. During last 20 years an enormous progress has been done in that field. Tumors of the nose an...
Praktyczne aspekty interakcji leków w farmakoterapii otolaryngologicznej, czyli 7 grzechów głównych leczenia farmakologicznego w praktyce lekarza otolaryngologa
Interakcje leków stanowią coraz większy problem w praktyce otolaryngologicznej. Stosowanie leków u pacjentów stosujących politerapię generuje ryzyko niekorzystnych interakcji leków, co wymaga specjalistycznej wiedzy w ty...