Vol.95 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 4 April 2002
Subcutaneous and Brain Abscesses Caused by
Frontal Sinusitis
Yutaka Higuchi, Hideo Nakamura, Hiromi Kondoh,
Masabumi Obata and Sugata Takahashi
(Niigata University)
Masaru Kawasaki
(Nagaoka Red Cross Hospital)
The patient was 14-year-old boy who complained of progressive forehead swelling and persistent slight fever. A CT scan revealed subcutaneous abscess, brain abscess in the right frontal lobe and frontal sinusitis. The patient underwent a drainage operation at which time bone destruction was noted in the skull, and the subcutaneous abscess was observed to be continuous with the frontal sinus.
Three months after neurosurgery, forehead pain recurred again, and CT and MRI showed left pansinusitis including frontal sinusitis. Right extranasal frontal sinusectomy and maxillo-etmoidectomy was performed to prevent intracranial complication. Additionally a bony defect was noted in the posterior wall of the frontal sinus. In this patient we considered that the infection had directly spread to the brain and subcutaneous forehead through the bony defect in the wall of the frontal sinus.
In cases of rhinogenic intracranial complications, the frontal sinus is considered to be the most probable origin of infection. The mechanisms for the intracranial spread of infection from the frontal sinus and the importance of surgical treatment against frontal sinusitis are also discussed.
Key words : brain abscess, frontal sinusitis, rhinogenic intracranial complication