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[Subdural empyema complicating acute frontal sinusitis. Four cases report]

A Tall1, M C Ba, A Beketi

  • 1CHU de Dakar, Clinique ORL et CCF (Service Pr Diop), Dakar, Sénégal.

Revue De Laryngologie - Otologie - Rhinologie
|September 27, 2005
PubMed
Abstract

Insights

Subdural empyema, a serious complication of sinusitis, requires prompt diagnosis and management. Early intervention involving surgical drainage and antibiotics is crucial for favorable outcomes, though vision loss can occur.

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Diseases
  • Otolaryngology

Background:

  • Subdural empyema is a rare but severe intracranial complication of paranasal sinus infections, particularly frontoethmoid sinusitis in children.
  • Prompt recognition and management are essential to prevent significant morbidity and mortality.

Observation:

  • A case series involving four young males with frontoethmoid sinusitis complicated by subdural empyema.
  • Diagnosis was confirmed via CT scans of the brain and sinuses.
  • Treatment involved simultaneous surgical drainage of sinuses and intracranial suppuration, coupled with a 4-week course of antibiotics.

Findings:

  • Subdural empyema occurred in the temporoparietal or frontal regions, with one case involving an interhemispheric collection.
  • Post-operative complications included transient seizures and focal neurological deficits in one patient, which resolved spontaneously.
  • While no deaths occurred, two patients experienced vision loss, one bilaterally.

Implications:

  • A high index of suspicion for intracranial extension of sinusitis is vital, necessitating prompt neuroradiological investigation.
  • Multidisciplinary management involving otorhinolaryngologists and neurosurgeons is critical for effective treatment of subdural empyema.
  • Despite aggressive treatment, potential for severe sequelae like vision loss underscores the importance of early detection and intervention.

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