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[Rhinosinusogenic subdural empyema in children]

A N Zinkin, M M Sergeev

    Vestnik Otorinolaringologii
    |October 26, 2005
    PubMed

    Insights

    Rhinosinusogenic intracranial complications in children can lead to subdural empyema. Early diagnosis and treatment, including sinus focus eradication and abscess drainage, are crucial for positive outcomes.

    Area of Science:

    • Pediatric Neurology
    • Infectious Diseases
    • Neurosurgery

    Background:

    • Rhinosinusogenic intracranial complications are serious conditions in children.
    • Subdural empyema is a rare but severe complication of rhinosinusitis.

    Observation:

    • A decade-long analysis (1994-2003) of 44 pediatric patients with rhinosinusogenic intracranial complications was conducted.
    • Ten patients (22.7%) were diagnosed with subdural empyema.
    • Early symptoms included severe headache, mental disorders, fever, and focal neurological deficits.

    Findings:

    • All patients exhibited systemic inflammatory response syndrome.
    • Treatment involved vital function correction, surgical cleansing of infection foci, and intensive postoperative care.
    • Postoperative therapy included broad-spectrum antibiotics (e.g., amoxicillin/clavulanate, vancomycin, cephalosporins, metronidazole), infusion, and symptomatic management.

    Implications:

    • Prompt diagnosis and multidisciplinary treatment are essential for managing pediatric subdural empyema.
    • Eradication of the primary sinonasal infection and surgical drainage of the empyema are critical interventions.
    • Effective antibiotic and supportive care regimens contribute to favorable patient outcomes.

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