Vol.95 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 5 May 2002
Three Cases of Rhinogenic Intracranial Complications
Kousuke Sekiyama, Yutaka Hanamure, Fujihiko Kasano and Naoko Kashima
(Kagoshima City Hospital)
We have encountered three cases of rhinogenic intracranial complications in the last two years. Case 1: A 17-year-old male had a subdural abscess secondary to acute sinusitis. He had right eyelid swelling (orbital cellulitis) and a frontal subcutaneous abscess. The transfrontal approach (Killian's method) and endoscopic sinus surgery (ESS) were carried out under general anesthesia. Drainage of the subdural space and 6 sessions of hyperbaric oxygen therapy were performed after the surgery. Case 2: A 14-year-old male had a brain abscess secondary to acute sinusitis. He exhibited severe headache and vomiting. Drainage of the subdural space did not improve the symptoms. He was then treated with ESS 9 days after the drainage. Case 3: An 18-year-old male had meningitis and a subdural abscess secondary to acute sinusitis. He had severe frontalgia and palsy of the left lower leg. ESS was carried out immediately. Hyperbaric oxygen therapy was performed 8 times after the surgery. The subdural abscess disappeared without any neurosurgical drainage. All cases were treated successfully without any complications. Careful observation, prompt diagnosis, and early surgical treatments are required to prevent excessive morbidity and mortality. ESS should be the first choice for the treatment of sinusitis with rhinogenic intracranial complications.
Key words : rhinogenic intracranial complications, acute sinusitis, endoscopic sinus surgery